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Pregnancy and lactation

Session: Poster Session B

(313) Specific congenital anomalies associated with maternal Multiple Sclerosis: A ConcePTION European case-malformed control study

Tuesday, August 27, 2024
8:00 AM – 6:00 PM CEST
Location: Convention Hall II

    Presenting Author(s)

  • MB

    Marie Beslay, PhD

    Post-doctorant
    CERPOP, Inserm U1295, Université de Toulouse Paul Sabatier, Service de Pharmacologie Clinique, CHU de Toulouse, France

    • Co-Author(s)

  • EC

    Erika Cifuentes-Castro

    CERPOP, Inserm U1295, Université de Toulouse Paul Sabatier, Service de Pharmacologie Clinique, CHU de Toulouse, France

  • Sudip Karki

    PhD Student
    CERPOP, Inserm U1295, Université de Toulouse Paul Sabatier, Service de Pharmacologie Clinique, CHU de Toulouse, France

  • AB

    Anna-Belle Beau, PhD

    Post-doctoral fellow
    CERPOP, Inserm U1295, Université de Toulouse Paul Sabatier, Service de Pharmacologie Clinique, CHU de Toulouse, France

  • JB

    Justine Bénévent

    CERPOP, Inserm U1295, Université de Toulouse Paul Sabatier, Service de Pharmacologie Clinique, CHU de Toulouse, France

  • MA

    Marie-Claude Addor

    Department of Woman-Mother-Child, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland, Switzerland

  • IB

    Ingeborg Barisic

    Children's Hospital Zagreb, Centre of Excellence for Reproductive and Regenerative Medicine, Medical School University of Zagreb, Zagreb, Croatia, Croatia

  • JB

    Jorieke Bergman

    Department of Genetics, EUROCAT Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands, Netherlands

  • CC

    Clara Cavero-Carbonell

    Rare Disease Research Unit, Foundation for Promotion of Health and Biomedical Research of Valencian Region (FISABIO), Valencia, Spain, Spain

  • EG

    Ester Garne

    Paediatric Department, Hospital Lillebaelt, Kolding, Denmark, Denmark

  • MG

    Miriam Gatt

    Malta Congenital Anomalies Registry, Directorate for Health Information and Research, Malta

  • JH

    Jonathan Hoareau

    Unit of congenital malformations, REMACOR- Medical School University of La Réunion St Pierre, France

  • ED

    Elly Den Hond

    Provincial Institute of Hygiene, Antwerp, Belgium, Belgium

  • AL

    Anna Latos-Bielenska

    Department of Medical Genetics, Poznan University of Medical Sciences, Poznań, Poland, Poland

  • NL

    Nathalie Lelong

    Paris Registry of Congenital Malformations, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, INSERM, UMR 1153, France

  • MO

    Mary O’Mahony

    Department of Public Health, Health Service Executive-South, Cork, Ireland, Ireland

  • AN

    Amanda J. Neville

    Department of Medical Sciences, Centre for Clinical and Epidemiological Research, Emilia Romagna Registry of Birth Defects, Ferrara University, Italy, Italy

  • AP

    Anna Pierini

    Unit of Epidemiology of Rare Diseases and Congenital Anomalies. Institute of Clinical Physiology-National Research Council, Italy

  • AR

    Anke Rissmann

    Malformation Monitoring Centre Saxony-Anhalt, Germany, Germany

  • JM

    Joan K. Morris

    Professor
    Population Health Research Institute, St George’s, University of London, UK, United Kingdom

  • HD

    Helen Dolk

    School of Medicine, Ulster University, Belfast, United Kingdom, United Kingdom

  • ML

    Maria Loane

    Institute of Nursing and Health Research, Ulster University, United Kingdom

  • CD

    Christine Damase-Michel

    CERPOP, Inserm U1295, Université de Toulouse Paul Sabatier, Service de Pharmacologie Clinique, CHU de Toulouse, France

Background: Multiple sclerosis (MS) is a rare neurological condition with an estimated prevalence of 0.5% in the general population. It is more common in women aged 20-40 years, raising the question of the impact of the disease and MS drugs on pregnancy outcomes.

Objectives: To assess the risk of congenital anomalies (CAs) associated with maternal MS.

Methods: A case-malformed control study was performed using data from the EUROmediCAT central database, including livebirths, fetal deaths from 20 weeks gestational age and terminations of pregnancy for fetal anomaly. We assessed the risk of CAs in children born to women with a recorded diagnosis of MS and/or who had been exposed to an MS-specific drug. Cases from 80 EUROCAT subgroups of non-genetic anomalies were compared with malformed controls (all other non-genetic anomalies or genetic conditions). Subgroups with ≥3 exposed cases were analyzed. Reporting Odds ratios adjusted (aROR) for year of birth, maternal age and registry, with 95% Confidence Intervals (95% CI) were estimated. P-values were adjusted for multiple testing.

Results: There were 253,911 children/fetuses born with CAs (registrants) in 12 European countries from 1995 to 2020. 20 women had both an MS diagnosis and a prescription for an MS-specific drug, 86 women had an MS diagnosis only and 10 women had a prescription for an MS-specific drug only. Among the 116 registrants born to mothers with MS, 95 were non-genetic CAs and 21 were genetic CAs. Of the 22 subgroups with ≥3 MS exposures, an increased risk of gastroschisis was associated with maternal MS status compared with non-genetic controls and with genetic controls (aROR 6.57, 95%CI: 2.05-21.05, adjusted p-value=0.044 and aROR 12.22, 95%CI: 3.48-42.93, adjusted p-value=0.022 respectively; 3 exposed cases).

Conclusions: We found a 6-fold increased risk of gastroschisis following maternal MS status during pregnancy. As maternal illness is known to be under-recorded in the central database, these findings require further investigation and verification in other independent datasets.