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Multiple Sclerosis and Pregnancy: A Comparison Study

Published online by Cambridge University Press:  23 September 2014

Sura Alwan ,
Magdalena Dybalski ,
Irene M. Yee ,
Talitha M. Greenwood ,
Elaine Roger ,
Nancy Nadeau ,
Pierre Duquette  and
A. Dessa Sadovnick
Sura Alwan
Affiliation:
Faculty of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia
Magdalena Dybalski
Affiliation:
Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia
Irene M. Yee
Affiliation:
Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia
Talitha M. Greenwood
Affiliation:
Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia
Elaine Roger
Affiliation:
Faculty of Medicine, University of Montreal
Nancy Nadeau
Affiliation:
Faculty of Medicine, University of Montreal Multiple Sclerosis Clinic, Hôpital Notre Dame du CHUM, Montreal, Quebec, Canada
Pierre Duquette
Affiliation:
Faculty of Medicine, University of Montreal Multiple Sclerosis Clinic, Hôpital Notre Dame du CHUM, Montreal, Quebec, Canada
A. Dessa Sadovnick*
Affiliation:
Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia
*
University of British Columbia, Vancouver Coastal Health Authority - UBC Hospital, S113-2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada. Email: sadovnik@infinet.net
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Abstract:

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Objective:

To determine whether different health care systems may affect reproductive decision-making among patients with Multiple Sclerosis (MS), we describe the reproductive practices and attitudes of Canadian MS patients ascertained from the multidisciplinary MS Clinic at Hôpital Notre-Dame in Montreal, Quebec (NDMSC), in comparison to those of matched American selfregistrants from the database of the North American Research Committee on Multiple Sclerosis (NARCOMS).

Methods:

A total of 665 self-administered questionnaires on reproductive practices were sent out to eligible attendees attending the NDMSC. The short questionnaires were completed and returned to the authors in an anonymous format for analysis.

Results:

A total of 459 completed questionnaires were returned. The majority of NDMSC respondents (72.5%) and NARCOMS subset (75.2% females), did not encounter a pregnancy following diagnosis of MS. The most common MS-related reason for this decision was “symptoms interfering with parenting” (75.0% for the NDMSC, 72.6% for the NARCOMS). The most commonly reported non-MS-related reason was “a completed family” by the time of diagnosis in both the NDMSC and NARCOMS subset (58.0%, 40.4%, respectively). Concerns about financial issues both related and unrelated to MS were also commonly reported by males and females in both cohorts but significantly more so among the NARCOMS participants.

Conclusion:

These results indicate that reproductive decisions of MS patients are highly affected by their illness and its associated disability, regardless of the available health care program. Health care providers should discuss their patients' reproductive needs and perceptions to help them make more informed decisions.

Résumé:

RÉsumÉ:Objectif:

Le but de l'étude était de déterminer si différents systèmes de santé peuvent influencer le processus de décision concernant la reproduction chez les patient(e)s atteint(e)s de sclérose en plaques (SP). Nous décrivons les pratiques et les attitudes concernant la reproduction des patient(e)s canadien(ne)s atteint(e)s de SP fréquentant une clinique multidisciplinaire de SP à l'Hôpital Notre-Dame, à Montréal, au Québec (CSPND) et nous les avons comparées à celles de patient(e)s américain(ne)s qui se sont inscrits à la base de données du North American Research Committee on Multiple Sclerosis (NARCOMS).

Méthode:

Six cent soixante-cinq questionnaires auto-administrés sur les pratiques en matière de reproduction ont été envoyés aux patient(e)s éligibles inscrit(e)s à la CSPND. Un bref questionnaire a été complété et retourné aux auteurs de façon anonyme.

Résultats:

Quatre cent cinquante-neuf questionnaires complétés ont été retournés. La majorité desrépondant(e)s de la CSPND (72,5%) et un sous-groupe de la NARCOMS (dont 75,2% étaient des femmes), n'ont pas eu de grossesse après avoir reçu un diagnostic de SP. La raison en relation avec la SP la plus souvent évoquée pour justifier cette décision était « des symptômes qui interfèrent avec le rôle de parent » (75,0% pour la CSPND, 72,6% pour la NARCOMS). La raison la plus souvent évoquée, qui n'était pas reliée à la SP, était « la famille était complète » au moment du diagnostic dans les deux sous-groupes, la CSPND et la NARCOMS (58,0% et 40,4% respectivement). Des préoccupations financières, tant reliées que non-reliées à la SP, étaient aussi fréquemment rapportées par les hommes et par les femmes des deux cohortes, mais significativement plus fréquemment par les participant(e)s de la NARCOMS.

Conclusion:

Ces résultats indiquent que les décisions des patient(e)s atteint(e)s de SP en matière de reproduction sont très influencées par leur maladie et l'invalidité qui y est associée, quel que soit le programme de soins de santé qui leur est disponible. Les professionnels de la santé devraient discuter avec les patient(e)s de leurs besoins et de leurs perceptions en matière de reproduction afin de les aider à prendre des décisions plus éclairées.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 4 , July 2013 , pp. 590 - 596
Copyright
Copyright © The Canadian Journal of Neurological 2013

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