The effect of postpartum intravenous immunoglobulins on the relapse rate among patients with multiple sclerosis

Objective: To evaluate the effect of intravenous immunoglobulins (IVIGs) on the expected increase in postpartum relapse rate (RR) among patients with multiple sclerosis (MS). Methods: In a retrospective study, data were analyzed from patients with relapsing remitting MS who received postpartum IVIG at the Academic MS Center Limburg, Sittard-Geleen, Netherlands, between April 2005 and January 2015. Patients received 10 g IVIG (Nanogam) for 3 consecutive days after childbirth, and then once monthly until 5 months after delivery. Data were compared with results from the Pregnancy in Multiple Sclerosis (PRIMS) I and II studies, which followed the natural outcomes of patients with MS with no intervention. Results: Overall, 42 pregnancies were evaluated. The RR in the first 3 months after delivery was 0.48 +/- 1.31, as compared with 1.2 in the PRIMS studies. The RR also remained low at 3-6, 6-9, and 9-12 months after delivery for patients who received IVIG. Conclusion: Postpartum administration of IVIG could be beneficial in preventing childbirth-associated relapses among patients with MS. It led to a substantial decrease in RR. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.