Impact of neurological diseases on family planning: A single-center experience

Prenatal and Postnatal Opinions and Experiences of Women With Multiple Sclerosis: A Phenomenological Study

BACKGROUND

Multiple sclerosis is an irreversible autoimmune disease with significant physical, psychological, and social impacts. Understanding the lived experiences of pregnant women with multiple sclerosis is vital for healthcare professionals to provide better care to these women.

PURPOSE

This study was designed to explore the lived experiences of pregnant women with multiple sclerosis.

METHODS

A descriptive phenomenological study was conducted at the University of Jaén and included 17 women from different Spanish provinces who were recruited using intentional and snowball sampling methods via national patient associations and social networks. In-depth interviews were conducted, audio-recorded, transcribed, and analyzed using Martins' three steps. The ATLAS.ti 7.0 program was used for data analysis.

RESULTS

Two themes and seven subthemes were identified that highlighted the experiences of women in pregnancy with multiple sclerosis: (a) the influence of the disease on the decision to be a mother, with subthemes "The disease determines when to be a mother" and "Considering alternatives to spontaneous pregnancy," and (b) the vision of motherhood with multiple sclerosis, with subthemes "Worry about how the disease can affect the pregnancy," "Worry about how the pregnancy can affect the disease," "Concerns about childbirth," "Difficulty with breastfeeding," and "Worry about the transmission of the disease."

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Women with multiple sclerosis often face a difficult decision regarding whether to become pregnant. The period of pregnancy and puerperium can be fraught with anxiety, especially in terms of concerns about their ability to raise children. In light of the limited scientific evidence regarding the relationship between multiple sclerosis and pregnancy and the conflicting advice often given to these women, the findings of this study may be used to help improve the quality of the care provided to this population.

The burden of myasthenia gravis - highlighting the impact on family planning and the role of social support

Background

Myasthenia gravis (MG) is a rare autoimmune disease and chronic condition that necessitates specialized care. Patients experience a significant burden of disease affecting various aspects of their lives. The aim of this study was to investigate the impact of MG on family planning, challenges associated with pregnancy, childcare responsibilities and the extent to which MG patients perceive and utilize social support.

Methods

This analysis used data from our main data of a large cross-sectional study built on a questionnaire-based survey encompassing 1,660 MG patients and members of the German Myasthenia Association (Deutsche Myasthenie Gesellschaft), and focused on sociodemographic, clinical and family planning relevant data points.

Results

Decisions regarding family planning were significantly impacted for individuals with MG when MG symptoms started either before or during their family planning (men: n = 19 and 29.7%; women: n = 156 and 58.4%). In this subgroup a substantial proportion opted against parenthood due to MG (men: n = 8 and 50.0%; women: n = 54 and 38.0% and/or another n = 12 and 8.4% of female participants encountered partner-related refusals). In the subgroup of female SP with MG starting before or during family planning who have reported ever been pregnant the self-reported miscarriage rate was 29.0% (n = 51). MG patients with medium incomes or moderate disease severity reported lower levels of perceived social support. 42.7% (n = 606) of participants needed assistance in negotiations with health insurers and 28.0% (n = 459) needed support for transportation to medical appointments.

Conclusion

This study shows a significant impact of MG on family planning decisions, affecting both women and men, and often resulting in life-altering decisions such as voluntary childlessness due to MG. The significance of social support becomes evident as a vital factor, especially when navigating through the healthcare system. Tailored healthcare approaches, organized guidance and comprehensive support is needed to enable informed decision-making and offer assistance for MG patients.

Clinical trial registration

https://clinicaltrials.gov/study/NCT03979521, Registered 7 June 2019 (retrospectively registered).

The Effect of Multiple Sclerosis on Family Planning Among Saudi Families

Background Multiple sclerosis (MS) is one of the most common neurological disorders in the world, and it is the leading cause of non-traumatic disability among young adults. While genetic susceptibility plays a role in MS development, the condition is not directly hereditary. Nevertheless, MS tends to aggregate within families, with first-degree relatives of affected individuals facing a higher risk than the general population. Additionally, family planning knowledge is insufficient among MS patients. Hence, this study aimed to assess the influence of MS disease on family planning and define the factors influencing decision-making regarding family planning in multiple sclerosis patients in the Eastern province of Saudi Arabia. Methodology A prospective study was conducted in Eastern Province, Saudi Arabia, during the period of 2022-2023 through directly interviewing the patients using a pre-validated questionnaire. This study would improve counseling and future care plans regarding family planning during patients' visits. Results A total of 57 women with MS were enrolled in this study; 35 (61.4%) patients got pregnant after the onset of the disease, and 46 (97.9%) had healthy children. A total of 23 (40.4%) were previously aborted due to the disease. Only five (8.8%) diseased women experienced relapses of the disease during previous pregnancies. A total of 14 (24.6%) women reported that generally their condition improved during pregnancy and childbirth, and 12 (21.1%) had no change, while four (7%) reported that their condition generally deteriorated. Also, 15 (26.3%) had no change in their condition during the first three months after birth, while four (7%) experienced deteriorated condition. Exactly 71.2% reported that the disease mostly affected their planning for pregnancy, which was of greater extent among 24.6% and partial among 14%. Conclusion Multiple sclerosis affects women's decisions regarding family planning. The most reported causes among affected women included anxiety about weakness and lack of strength during childbirth, concern about possible side effects from MS drugs on the fetus (congenital malformations), worry about not being able to take care of a child due to illness and the severe impact of the disease on their health.