Better Prognosis of Multiple Sclerosis in Patients Who Experienced a Full-Term Pregnancy

Abstract

Objective: We conducted a longitudinal prospective study to evaluate the long-term effect of pregnancy on the progression of multiple sclerosis (MS). Method: Parous female MS patients were extracted from the database of Isfahan Multiple Sclerosis Society (IMSS). Through comparing the annual relapsing rate during a mean of 4 years before pregnancy versus a mean of 6 years after delivery, MS progression influenced by the pregnancy was analyzed. Result: 102 female patients were included in our study. The mean annual relapsing rate 4 years prior to pregnancy was significantly higher than at the subsequent 6 years after delivery (1.06 vs. 0.45, p < 0.001). In addition, the annual relapsing rate in years prior to pregnancy was significantly higher than each trimester of gestation (p < 0.001). Furthermore, there was a 2.2-fold increased risk of having a relapse in individuals who had experienced more relapses prior to pregnancy, and a 0.8-fold decreased in the risk of having more relapses with older age at the onset of MS. Conclusion: Although the course of MS was deteriorated 3 months after delivery, it was not statistically significant comparing annual relapsing rates during the years prior to pregnancy. Moreover, the rate of disease progression slowed down in the 6-year period monitored after delivery.

Management of women with multiple sclerosis through pregnancy and after childbirth

“…This turned out to be untrue. Some studies suggest pregnancy conveys a long-term benefit [Keyhanian et al 2012;Masera et al 2015;Runmarker and Andersen 1995;Verdru et al 1994], while others find no long-term impact [Karp et al 2014;Ramagopalan et al 2012]. The most accurate current counseling would be to inform patients that pregnancy has no negative effect on long-term prognosis.…”

Female Gender and Reproductive Factors Affecting Risk, Relapses and Progression in Multiple Sclerosis

“…The strength of evidence was based upon criteria used in a systematic review of prognostic factors of whiplash-associated disorders (table 2B) [45]. An overview of the most important findings is given in table 3[46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75]. …”

The implications of autoimmunity and pregnancy

“…Indeed, a recent study from Iran indicates that disease progression slowed in the 5 years after childbirth, despite an increased flare rate immediately post-partum [76]. In addition, the results of several investigations (from Sweden, Belgium, the Netherlands, and Denmark) suggests that pregnancy after disease onset is associated with less disability and a lower risk of changing from a relapsingremitting to a chronic progressive course.…”