Effectively Managing Neuroimmunology Conditions During Pregnancy: UPMC Lauches Dedicated Neuroimmunology and Pregnancy Clinic

Pregnancy in women with multiple sclerosis (MS) and related neuroimmunologic conditions has historically required balancing disease control against concerns about fetal exposure to therapy. Earlier treatment approaches often involved discontinuing disease-modifying therapy before conception and while pregnant, leaving patients vulnerable to relapse, especially in the postpartum period. That approach was driven by limited therapeutic options, incomplete safety data, and lack of provider understanding on caring for women with MS and related conditions who want to become pregnant, or who are.

Over the past decade, the introduction of higher-efficacy therapies and expanding observational data have changed how pregnancy can be managed in relation to underlying neuroimmunologic disease.

Treatment decisions increasingly depend on timing rather than discontinuation, including when therapies are administered relative to conception, how medication exposure changes and must adapt across trimesters, and how treatment is resumed after delivery.

These clinical decisions require interpretation of evolving data, pharmacologic considerations such as placental transfer, and careful planning to reduce postpartum relapse risk while maintaining fetal safety.

About The New Neuroimmunology and Pregnancy Clinic at UPMC

The Neuroimmunology and Pregnancy Clinic within the UPMC Multiple Sclerosis Center, led by Ingrid Loma-Miller, MD, assistant professor of neurology at the University of Pittsburgh School of Medicine and assistant chief of the Division of Neuroimmunology/MS, is now fully operational, seeing patients, and taking referrals from providers.

“In the past, women with MS often felt they had to choose between being pregnant and preventing relapses,” Dr. Loma-Miller says. “Now we can keep patients on effective therapies, monitor them closely, and help them go through pregnancy while maintaining disease stability.”

The clinic provides structured counseling and longitudinal care for women with multiple sclerosis, neuromyelitis optica spectrum disorder, myelin oligodendrocyte glycoprotein antibody disease, and related immune-mediated neurologic conditions who are planning pregnancy, currently pregnant, or in the postpartum and lactation period.

The clinic operates as a consultative service within the UPMC Multiple Sclerosis Center, with one half-day per week dedicated to in-person visits and an additional half-day conducted virtually. This structure allows patients from across western Pennsylvania and surrounding regions to access pregnancy-specific neuroimmunology consultation while maintaining ongoing care with their primary neurologist.

As treatment options have expanded and pregnancy-specific data have accumulated, counseling for women with multiple sclerosis and related neuroimmunology disorders has become increasingly individualized. These changes have introduced new complexity for patients and referring physicians. Questions about medication timing, relapse risk, breastfeeding, and postpartum management often require coordination between neurology and obstetrics, as well as familiarity with evolving evidence that many clinicians encounter infrequently.

In a companion Q&A, Dr. Loma-Miller talks about how pregnancy management in multiple sclerosis and related neuroimmunology conditions has changed in recent years and discusses how treatment decisions are approached before conception, during pregnancy, and in the postpartum period, including how the clinic works with referring neurologists and obstetric providers and how research collaboration informs patient counseling.

Patient Referrals

For more information, visit the UPMC Multiple Sclerosis Center or contact the center for referrals and consultation at 412-641-6600.