Does Multiple Sclerosis Increase Pregnancy-Related Risks?

Question: Does Multiple Sclerosis Increase Pregnancy-Related Risks?

The effect of multiple sclerosis on pregnancy and pregnancy outcomes has been a bit understudied, although there is quite a bit of data about the effect of pregnancy on MS (symptoms lessened during pregnancy, increased risk of relapse in postpartum period, etc.). With advances in MRI diagnostic technologies, however, the average age of a multiple sclerosis diagnosis is likely to fall as people get diagnosed sooner after experiencing their first symptoms. If more women with the desire to have children will be diagnosed with MS, it is important to know what pregnancy-related risks are linked with multiple sclerosis.

Answer: A Taiwanese study looked at this very question in a systematic way using a national database of health outcomes. From 2001 to 2003, they identified 174 women with multiple sclerosis who gave birth. These women were "matched" to 1,392 other women who gave birth and fit the same pregnancy risk categories (age, prior pregnancies, etc.). They then compared the pregnancy outcomes to try to determine the impact of multiple sclerosis on pregnancy-related risks.

They found that women with multiple sclerosis were 2.25 times more likely to have a preterm birth, 1.89 times more likely to have babies who were smaller than average for gestational age and were more likely to have a cesarean delivery (c-section).

So, it looks like there is an increase in pregnancy complications linked to multiple sclerosis (at least in this study population). The good news is that most of these complications are manageable through good obstetric care. What is interesting is that there is no real explanation given for these differences in pregnancy risk. My take on this is that women with multiple sclerosis who are pregnant should be classified as "high-risk" and seek the best obstetric care possible.

A side note: One thing that I found just as interesting was the fact that the participants were all Asian (Taiwanese). Multiple sclerosis is very rare among Asians (the best estimate/extrapolation that I could come up with is 5 to 8 per 100,000 in the region, compared to 130 per 100,000 in the U.S. and 240 per 100,000 in Canada). Just thought it was worth mentioning.

Read More: Multiple Sclerosis and Pregnancy

_Sources:

Chen Y, Lin H, Lin H. Does multiple sclerosis increase risk of adverse pregnancy outcomes? A population-based study. Mult Scler. 2009 Mar 24.

Altas of MS. Multiple Sclerosis International Federation. Accessed: March 2009.