The dissolution of Roe v. Wade is supposed to lead to abortion severe bans or restrictions in 28 states. These new restrictions could have life-changing and even life-threatening consequences in these states for women of childbearing age with conditions like migraines, multiple sclerosis (MS). ) and epilepsy.
In their opinion paper, published in JAMA Neurology, neuroscientists from UC San Francisco focus on the dangers that abortion restrictions pose to women of reproductive age, suffering from disproportionately affected by these conditions and the drugs that treat them. These include drugs that are unsafe during pregnancy and so-called teratogens that have been linked to birth defects in the developing embryo and fetus.
“In the context of increasing reproductive rights restrictions, where it is not possible to reliably determine the duration or prevent pregnancy, neurologists may limit the use of effective drugs that are prescribed standard care for other patient populations because of potential concerns about harm to the fetus,” the respective authors wrote. Sara LaHueMD, of the UCSF Department of Neurology and UCSF Weill Institute for Neurosciences. “This may increase the risk of irreversible morbidity, mortality and cumulative disability for women with neurological diseases.”
Women with certain neurological conditions, including epilepsy, face the possibility of an unwanted pregnancy, as some treatments can make hormonal contraceptives less effective. . For patients with epilepsy, a type of seizure that can lead to brain damage or death, valproic acid, a teratogen, may be needed to stop the seizures.
Other teratogenic drugs include methotrexate and mycophenolate mofetil, which treat autoimmune disorders such as MS and myasthenia gravis. “Even when prescribed for a neurological condition, there are reports from patients across the country who say they have no access to methotrexate because it can also be used to disrupt,” says LaHue. pregnant.
Some drugs removed for all women of reproductive age
“Tactanogens are prescribed only when a woman can plan a pregnancy and prevent fetal exposure. However, controlling the duration of teratogen use may not be feasible in the short term,” said LaHue, referring to status epilepticus, encephalitis and vasculitis.
Monoclonal antibody treatments are indicated for patients with migraine, MS, and myasthenia gravis, but may not be safe during pregnancy. According to the authors, some neurologists may rule out these drugs for all women of reproductive age.
“In many settings, women with MS are treated with less effective therapies, because these drugs are thought to be safer during pregnancy,” said co-author. Riley Bove, MD, MSc, of the UCSF Department of Neurology and the Weill Institute for Neuroscience. “Typically, neuroscientists don’t know how to time or optimize certain drugs or their updated safety profile. Roe and Wade’s reversals may reinforce the decision to stick with less effective therapies, which can lead to irreversible disability for some women with MS. “
The authors conclude that reproductive health availability is “indispensable for the equitable delivery of neurological care. Equity in care depends on the unrestricted freedom to make personal decisions that affect body autonomy, including “optimization of reproductive mechanisms, individual identification of duration of pregnancy to limit the progression or exacerbation of disease, and to terminate the pregnancy if necessary for the health of the mother, the fetus, or both.
Source: UCSF
