Women with Multiple Sclerosis Can Have Healthy Pregnancies, Babies

Researchers from the University of British Columbia, Canada, and Newcastle University, United Kingdom, have good news for women with multiple sclerosis (MS): they can have healthy babies and pregnancies like their non-MS maternal counterparts.

Mia L. van der Kop from the division of neurology at the University of British Columbia and colleagues conducted a retrospective cohort study using British Columbia’s MS Clinic databases and the perinatal database registry. They looked at the birth results for 432 women with MS and compared that with results from 2975 matched women without MS. Outcomes studied included gestational age, birth weight, assisted vaginal delivery, and cesarean birth; the authors also looked at age at MS onset, disease duration, and disability as well as potential confounding factors.

Women in both groups had a median age of 32 years. Slightly more women with MS were nulliparous than their control counterparts (48.4% vs 41.6%, respectively). While more women in the control group had diabetes (7.5% vs 3.9%), more women in the MS group had gestational hypertension (7.6% vs 5.3%). More women with MS had a high body mass index, indicating they were overweight or obese, although the researchers speculate this could be due to the physical restrictions associated with the disease’s disabilities.

The majority of the women with MS had relapsing-remitting disease; 18 births resulted from women in secondary progressive phase, and 4 women with MS had primary progressive disease. Most women had Expanded Disability Status Scale scores indicating mild disability; however, 49 women had scores indicative of moderate to severe disability and 58 had scores indicating no disability. At delivery, median disease duration was 7 years, with median age of onset at 24 years.

MS was not significantly associated with assisted vaginal (odds ratio = 0.78) or cesarean delivery (OR = 0.94). Women with moderate to severe disability had slightly higher odds ratios, but the differences were not significant. In addition, birth weights were similar among women with MS and those women in the control group.

The researchers noted that their study should be reassuring to patients with MS who are considering starting a family. “This study provides reassurance to MS patients that maternal MS is generally not associated with adverse neonatal and delivery outcomes,” Van der Kop and colleagues concluded. “However, the suggestion of an increased risk with greater disability warrants further investigation; these women may require closer monitoring during pregnancy.”

More Information

National MS Society: Pregnancy and Reproductive Issues Expanded Disability Status Scale form

References:

References

van der Kop ML, Pearce MS, Dahlgren L et al.Neonatal and delivery outcomes in women with multiple sclerosis.  Ann Neurol. Jun 27, 2011 [Epub].
Walsh N.Birth outcomes good in mothers with MS. Medpage Today. June 27, 2011.