Pregnancy Generally Safe in Multiple Sclerosis

Canadian researchers have found that maternal multiple sclerosis is generally not associated with adverse delivery outcomes or risk to their offspring.Multiple sclerosis is a chronic, inflammatory neurologic disease and the most common cause of non-traumatic neurological disability in young adults in the Western world. Nearly 75% of multiple sclerosis patients are women who often experience disease onset in early adulthood—a time when many consider starting a family. Prior studies report that up to one-third of women with multiple sclerosis bear children after disease onset, underscoring the need to understand the effects of maternal multiple sclerosis on pregnancy outcomes, which is the focus of the current study by Mia van der Kop, a member of the multiple sclerosis research group led by Dr. Helen Tremlett.

The research team analyzed data from the British Columbia (BC) multiple sclerosis Clinics’ database and the BC Perinatal Database Registry between 1998 and 2009. Researchers identified 432 births to women with multiple sclerosis and 2975 to women without the disease, comparing gestational age, birth weight, type of birth (vaginal versus caesarean section). Age at multiple sclerosis onset, disease duration and level of disability were also examined.

Results showed that babies born to mothers with multiple sclerosis did not have a significantly different mean gestational age or birth weight compared to babies born to healthy mothers. Mothers with multiple sclerosis were not more likely to have a vaginal delivery or C-section. Researchers noted that multiple sclerosis mothers with greater levels of disability had a slightly elevated risk of adverse delivery outcomes. This finding was not statistically significant and further investigation was suggested. Age at onset of multiple sclerosis and duration of disease were not linked to adverse delivery or neonatal outcomes.

“Our finding that multiple sclerosis was not associated with poor pregnancy or birth outcomes should be reassuring to women with multiple sclerosis who are planning to start a family,” said Dr. Tremlett. The authors did note that multiple sclerosis mothers were more often overweight or obese, which is associated with greater risk during pregnancy and birth. Researchers suggest that these women be advised to optimize their weight prior to becoming pregnant. “The importance of body mass index and pregnancy-related outcomes in multiple sclerosis should be explored in future studies,” M. van der Kop concluded.