Italian Delphi Consensus on Maternity Care in Multiple Sclerosis: Toward an Interdisciplinary Model of Care.

BACKGROUND

Reproductive health is a critical component of care for women with multiple sclerosis (MS), yet standardized interdisciplinary approaches remain limited.

OBJECTIVES

This Delphi consensus aimed to develop an interdisciplinary, evidence-informed care model tailored to the Italian healthcare system.

RESULTS

A two-round Delphi process was conducted in Italy (June-July 2025), involving MS experts (Round 1: 107, Round 2: 95), including neurologists, gynecologists, pediatricians, nurses, and patient representatives. Participants evaluated key aspects of the reproductive care pathway, from preconception counseling to postpartum follow-up, to identify priorities and areas of agreement across disciplines. Strong consensus was achieved on the importance of early counseling, coordinated interdisciplinary management, and individualized treatment planning across the reproductive continuum. The central role of nurses in patient education was also emphasized. Divergence emerged regarding the continuation of specific therapies during pregnancy and the role of neonatal immunological monitoring following exposure to depleting agents, reflecting areas of ongoing uncertainty and limited evidence.

CONCLUSIONS

This consensus proposes the first interdisciplinary framework for reproductive care in MS within the Italian context. It emphasizes patient-centered decision-making, collaboration across specialties, and the integration of reproductive health into routine MS management. By identifying both shared priorities and unresolved challenges, it provides a foundation for more harmonized, evidence-informed clinical practice and future research.