A Multicenter International Study to Evaluate Different Aspects of Relationship Between MS and Pregnancy

Abstract

Since multiple sclerosis (MS) commonly affects women of child-bearing age, having a deeper understanding of «the effects of pregnancy on the disease» and «the effects of MS on pregnancy» is important.Although,studies on the effects of pregnancy and usage of disease-modifying therapies on MS are still ongoing, there is also a need to gather information regarding the reproductive practices and the attitude of females with MS in different countries. Females diagnosed with MS were included if they had at least one conception with complete clinical data (n=701).Data were obtained from medical records and the questionnaire which was specifically designed for this study.Detailed demographics, clinical information, data regarding the pregnancies,abortions, relapses during pregnancy and post-partum first 3 months,the presence of drug exposure during pregnancy, lactation, reproductive attitudes of females after being diagnosed as MS were collected. 1692 pregnancies in 701 females were evaluated.While mean age at MS onset was 28 ± 9 years, mean age during recruitment was 37 ± 9 years. The majority of patients (85.9%) had relapsing-remitting MS (RRMS). The mean EDSS was 2.0 (±1.8) (0–8). The number of pregnancies recorded was more frequent in the pre-MS than post-MS period. The mean age at first pregnancy was 24.32(±6.72). In total, 22.6% of 124 attacks during pregnancy were recorded in the first trimester; while 17.7% in the last trimester,45.2% during the post-partum period.Our data revealed that as the number of pregnancies increased, the age of MS onset was delayed. The number of pregnancies had no significant effect on the course of MS, Expanded disability Status Scale (EDSS) progression and transition to progressive phase. 184 patients (26.25 %) stated that the diagnosis of MS had an impact on their decision not to become pregnant.