Pregnancy and the Postpartum Period Have Protective Effects on Multiple Sclerosis Relapses:

Presented at ECTRIMS

PRAGUE, CZECH REPUBLIC –

During pregnancy, relapsing remitting multiple sclerosis (MS) has no distinct unfavourable effects on pregnancy, labour and delivery, according to a longitudinal prospective study presented on behalf of the Isfahan MS Society.  

In fact, the researchers said at the 23rd Congress of the European Committee for Treatment and Research in Multiple Sclerosis, 2007, women with MS derive long-term benefits from pregnancy and childbirth, achieving long-term MS relapse to at least 5 years postpartum.  

­          Amir Hadi Maghzi,

­          Medical Student with

­          Masoud Etemadifar,

­          Director, Institute of Isfahan Research Committee of Multiple Sclerosis, and

­          Professor of Neurology,

­          Isfahan University of Medical Sciences,

­          Isfahan, Iran,

presented the findings in a poster presentation. The rate and prevalence of MS is increasing considerably in Iran, although previously it was thought to be a very low-risk region for MS.  With the large population bias in favour of females in Iran, this has led to concern for both mother and baby during pregnancy and delivery, Maghzi said.  Previous studies indicated the potential for beneficial effects for the mother during pregnancy, but the long-term effects of MS and whether delivery might elevate the risk of relapse has remained a concern in women with MS.

This study was therefore conducted to examine the MS disease course in women with relapsing remitting MS, assessing mean annual relapse rates for the 5 years prior to pregnancy, during pregnancy (three tri-mesters, plus 3 months postpartum), and for up to 5 years postpartum.

Of 1,407 women registered at the MS centre, 102 were included for whom full medical records were available over the study period, excluding those who did not reach full-term delivery, and those who did not achieve a live birth.

The mean annualized rate of relapses in the 5 years prior to pregnancy was significantly greater than during pregnancy (1.06 vs. 0.56; [P <.002), and was greater than during the 5 years postpartum (1.06 vs. 0.50; P <.001).

However, as expected, for the first year postpartum, there was a significant increase in mean annualized relapse rate compared with the year of pregnancy (0.76 vs. 0.56; P <.001), although it still remained significantly lower than the 5 years before the pregnancy (0.76 vs. 1.06; P <.002).

The direct comparison of these relapse rates during the year of pregnancy and for the 5 years postpartum showed no significant difference (0.56 vs 0.50; P =.36), indicating long-term beneficial effects of pregnancy for these patients with MS, the researchers noted.

Therefore, these findings demonstrate not only that pregnancy has no adverse effects on the rate of MS relapses, but it also provides further evidence of the beneficial effects both of pregnancy and the postpartum period, over the long term, indicating a better prognosis for these patients with MS following full-term pregnancy.