Maternal Multiple Sclerosis and Health Outcomes Among the Children: A Systematic Review

Abstract

Objective To summarize the available literature and provide an overview of in utero exposure to maternal multiple sclerosis (MS) and the influence on offspring health outcomes. Methods We conducted a systematic review by searching Embase, Medline and PubMed.gov databases, and we used covidence.org to conduct a thorough sorting of the articles into three groups; 1) women with MS and the influence on birth outcomes; 2) women with MS treated with disease-modifying therapy (DMT) during pregnancy and the influence on birth outcomes; and 3) women with MS and the influence on long-term health outcomes in the children. Results In total, 22 cohort studies were identified. Ten studies reported on MS without DMT and compared with a control group without MS, and nine studies on women with MS and DMT prior to or during pregnancy met the criteria. We found only four studies reporting on long-term child health outcomes. One study had results belonging to more than one group. Conclusion The studies pointed towards an increased risk of preterm birth and small for gestational age among women with MS. In terms of women with MS treated with DMT prior to or during pregnancy, no clear conclusions could be reached. The few studies on long-term child outcomes all had different outcomes within the areas of neurodevelopment and psychiatric impairment. In this systematic review, we have highlighted the research gaps on the impact of maternal MS on offspring health.

Autoimmune diseases and adverse pregnancy outcomes: an umbrella review

“…The critical domains—meaning that a review would be rated as high quality review—were as follows: protocol registered before the commencement of the review (item 2), adequacy of the literature search (item 4), justification for excluding individual studies (item 7), risk of bias from individual studies being included in the review (item 9), appropriateness of meta-analytical methods (item 11), consideration of risk of bias when interpreting the results of the review (item 13), and assessment of presence and likely impact of publication bias (item 15) [ 132 ]. The five reviews which were excluded did not qualify on at least three of these critical domains [ 45 , 57 , 87 , 93 , 95 ]. The five reviews which were excluded did not qualify on at least three of these critical domains.…”

“…Random effect meta-analysis was conducted to obtain the pooled estimate from the primary studies from these reviews without double counting. Details of how the citation matrix was created and the CCA calculated are given in Additional file 1 : Text S1 [ 29 , 30 , 33 – 35 , 38 , 41 , 45 , 48 , 53 , 55 , 63 , 66 , 78 , 88 , 96 , 97 , 103 , 106 , 108 , 110 – 113 , 115 – 117 , 119 , 120 , 122 – 125 , 127 – 130 , 132 – 142 ] and Additional file 1 : Tables S7 and S8. After consultation with experts, we decided that none of the reviews required an update.…”

“…Full-text screening of eligible studies was conducted by two independent reviewers (MS, SW), and a third senior reviewer (FC, KN) was consulted to resolve any discrepancy. The list of excluded studies with reasons for excluding them is shown in Additional file 1 : Table S4 [ 31 , 45 – 103 ]. We found four non-English reviews.…”

Multiple Sklerose in Schwangerschaft und Stillzeit

“…In einem aktuellen systematischen Review wurde eine potenzielle Assoziation zwischen MS und einem niedrigeren Geburtsgewicht bei Neugeborenen festgestellt. Darüber hinaus zeigte sich in der MS-Gruppe im Vergleich zur Allgemeinbevölkerung eine erhöhte Prävalenz von Kindern mit einem Gewicht, das für ihr Gestationsalter zu niedrig war [5].…”

Well-being among parents of youth with multiple sclerosis: a preliminary longitudinal study

“…The overall well-being of such parents is thus likely impacted, and although extensive research exists on how MS in parents affects the psychosocial and health conditions of children and adolescents (e.g., Andersen et al, 2023 ; Haker et al, 2023 ), very little research exists on how children’s MS affects parental well-being ( Uccelli et al, 2013 ; O’Mahony et al, 2019 , 2022 ). Furthermore, most of the studies that do exist are cross-sectional, despite the chronic nature of POMS and its long-term burdens, such as diminished daily functioning of the patient, financial strains, and the unpredictable progression of the disease, which are factors that could potentially diminish parental well-being ( Hebert et al, 2019 ; O’Mahony et al, 2019 ).…”