Pregnancy Safe for Women With Multiple Sclerosis

July 1, 2011 — Women with multiple sclerosis (MS) considering having a child have a new reason to move forward with their plans, say investigators. The results of their new study are good news for young families affected by this chronic neurologic disease.

"Our finding that MS was not associated with poor pregnancy or birth outcomes should be reassuring to women who are planning to start a family," senior investigator Helen Tremlett, PhD, from the University of British Columbia in Vancouver, said in a news release.

The work was published online June 27 in the Annals of Neurology. The findings confirm national data showing women with MS or epilepsy are generally having safe pregnancies.

An estimated 75% of MS patients are women who tend to experience disease onset in early adulthood — a time when many consider having children.

The researchers analyzed data from the British Columbia MS Clinics' database and the province's Perinatal Database Registry. Investigators identified 432 births to women with MS and 2975 to women without the disease. They compared gestational age, birth weight, and type of birth. They also looked at age at disease onset, disease duration, and level of disability.

Investigators found that infants born to mothers with MS did not have a significantly different mean gestational age or birth weight compared with infants born to mothers without the disease. MS was also not significantly associated with assisted vaginal delivery or caesarean section.

Table. Odds Ratio of Vaginal Delivery or Caesarean Section

Type of Birth	Odds Ratio (Confidence Interval)	P Value
Vaginal delivery	0.78 (0.50 – 1.16)	.20
Caesarean section	0.94 (0.69 – 1.28)	.69

There was a slightly elevated risk for adverse delivery outcomes among mothers with greater levels of disability, the researchers point out; however, the findings were not statistically significant. Disease duration and age at MS onset were not significantly associated with adverse outcomes.

The study authors pointed out that mothers with MS were more often overweight or obese, which is associated with greater risk during pregnancy and birth.

"The importance of body mass index and pregnancy-related outcomes in MS should be explored in future studies," added lead investigator Mia van der Kop, MSc, also at the University of British Columbia.

In the meantime, the researchers recommend that women be advised to optimize their weight before becoming pregnant.

This study was funded by the Canadian Institutes of Health Research. The British Columbia Multiple Sclerosis database was funded by an unrestricted grant from Dr Donald Paty and the Multiple Sclerosis and Magnetic Resonance Imaging Research Group. The researchers have disclosed no relevant financial relationships.

Ann Neurol. Published online June 27, 2011.

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