For many people, pregnancy is equal parts thrilling and terrifying. For one, you’re growing a tiny human in your body, which is very cool. But growing a tiny human also means a lot of changes and decisions to make about your health and the health of your unborn child(ren).
Any considerations become even more complicated if you’re living with a chronic illness. Many chronic conditions require lifelong treatment, and pregnancy may affect the type of medication you take — and whether you can even take medication at all.
This is where pregnancy registries come in.
Read: Family Planning with a Chronic Health Condition >>
What is a pregnancy registry?
A registry is a database that collects information on people with specific health conditions. The data can be used to help improve patient care, public health programs and research overall.
A pregnancy registry is no different. “Pregnancy registries … are often focused on looking at a particular treatment or set of treatments that might be used for an underlying condition,” said Christina Chambers, Ph.D., MPH, associate director of the Altman Clinical & Translational Research Institute at the University of California, San Diego.
The information collected during a pregnancy registry can be life-changing for people living with a chronic illness — especially people with multiple sclerosis (MS).
“People with chronic conditions like MS present a number of challenges in terms of the best treatment and providing the best health outcomes. And then when it comes to pregnancy, there's a whole set of other questions that come up,” Chambers said.
Pregnancy registries and MS
MS is an autoimmune condition that affects your brain and spinal cord. Most women and people assigned female at birth (AFAB) are diagnosed with MS in their reproductive years. But there’s not a lot of research when it comes to MS and pregnancy. This is because, in the past, disease-modifying therapy (DMT) trials didn’t include pregnant people. So, if you were enrolled in a trial, you had to quit if you got pregnant.
For a long time, people with MS were told not to get pregnant at all because treatments could potentially harm the unborn child. It wasn’t until 2002 that the FDA required drug makers to create pregnancy registries for people with MS. The registries were set up to help gather information on the effect of DMTs before, during and after pregnancy. The registries also keep a record of outcomes, including miscarriages and birth defects. In other words, they gather information to find out whether medications are safe for pregnancy.
“It's one of the reasons why we do pregnancy registry studies — so people who either find out they're pregnant or taking the drug or were considering taking it in a future pregnancy can feel relatively reassured that there isn’t evidence to suggest [harm],” Chambers said.
We now know that people with MS can have healthy pregnancies. In fact, studies show that the rates of birth defects and pregnancy or delivery complications are about the same for people with MS compared to people without MS.
Still, there’s little information on the effects of DMTs and other medications on pregnancy for people with MS. The lack of research has left a huge gap in the data, and many of the newer medications are still being researched to determine safety and side effects during pregnancy.
Read: FAQs About Delivery, Breastfeeding and Postpartum Care with Multiple Sclerosis >>
How to sign up for a registry
Joining a registry can help fill the gaps in information. Chambers noted that different registries have different requirements. Some registries only collect reporting from healthcare providers (HCPs). Others use reporting from the pregnant person and information from the provider. “All of the [registries] that we do — and many other ones as well — consider the mother the primary source,” Chambers said.
How and when to sign up can also vary per registry. In many cases, a neurologist or HCP will refer the person to a registry. From there, it’s up to that person to decide if it’s a good fit.
Online resources such as MotherToBaby, MSBase Registry and the National Multiple Sclerosis Society can also help connect people to open registries. Drug makers may also promote pregnancy registries online.
Chambers said it’s important to learn everything you can early on about the registry and ask questions about the time commitment — some studies can go on for years — and what’s expected from you during that time.
Pregnancy registries and privacy
It’s also important to know who your information will be shared with. Privacy and confidentiality are valid concerns when you’re sharing important details like medical records and personal information. Part of the consent process includes how confidentiality is being protected, how the information is being stored and that no identifiable information is shared outside the staff working on the study. “So nobody could go say, ‘Mrs. So-and-So took part in the study’ — that would not happen,” Chambers said. “[The participant] can feel assured that she's not going to see her picture or her name in a paper and that her identity is protected throughout the study.”
The one exception is if someone wanted to be part of a testimonial after participating in a registry. But, again, that’s up to the person in the study.
Women helping women
Pregnancy registries provide an opportunity to help other people with MS make educated decisions about pregnancy and treatment. The information collected can even affect decisions made long before a pregnancy is confirmed. That’s pretty powerful stuff. “We hear that over and over again … people saying I'm doing this because I wish I had known or I wish I had this information, so I want to make sure that the next person does have it,” Chambers said. “The moms who do it — they’re amazing. They are contributing their time and their personal information. It’s a really gracious thing that they do.”
Resources
National Multiple Sclerosis Society
This educational resource was created with support from Novartis, a HealthyWomen Corporate Advisory Council member.
