Abstract
Many neuroinflammatory disorders have a predilection for women; even if there is no
female predominance, neuroinflammatory conditions in women pose a management challenge
for several reasons. Disease activity of these conditions may change during pregnancy
and commonly increases in the postpartum period. Uncontrolled disease activity may
affect pregnancy outcomes. Moreover, immunomodulating agents that are used to suppress
the disease activity may have a negative impact on fertility, pregnancy, and fetal
outcomes, and on infants who are breastfed. Adverse effects of immunosuppressants
extend beyond the reproductive issues and may include bone loss, increased risk of
cancers, and infectious complications. The successful management of women with these
disorders requires that not only practitioners understand and recognize the adverse
effects of immunosuppressants, but also seek to prevent adverse outcomes through counseling
about contraceptive choices, safety monitoring, risk surveillance, and other strategies.
Keywords
neuroinflammatory disorders - immunosuppressants - fertility - pregnancy - lactation
