A multicenter multinational study to evaluate different aspects of the relationship between MS and pregnancy

• Published in: Multiple sclerosis and related disorders Vol. 91; p. 105811
• Main Authors: Gozubatik-Celik, R.G., Sen, S., Tay, B., Alroughani, R., Zakaria, M., Moghadasi, A.N., Terzi, M., Koseoglu, M., Efendi, H., Soysal, A., Ozturk, M., Akinci, Y., Kaya, Z.E., Saip, S., Siva, A., Sahraian, M., Gonen, M., Altintas, A.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.11.2024
• Subjects: Fetus outcomes; Low birth weight; Multiple sclerosis; Pregnancy; Prognosis; Pregnancy; Multiple sclerosis; Prognosis; Fetus outcomes; Low birth weight
• ISSN: 2211-0348; 2211-0356; 2211-0356
• DOI: 10.1016/j.msard.2024.105811

•This retrospective international multicenter study emerges as the first in this region to gather data regarding the effect of pregnancy on MS and the effect of MS on the reproductive attitude.•82.3 % of females with MS had no relapses during pregnancy and postpartum period.•The patients with a higher number of pregnancies before MS had later onset with more disability.•The reason for the lower number of pregnancies after mS was the hesitancy of the patients, which mostly related with the fear of severe disability. To investigate the pregnancy-related issues in females with multiple sclerosis (MS) from Turkiye, Egypt, Kuwait, and Iran. 1692 pregnancies of 701 females with MS were evaluated in this retrospective multicenter, international project. Demographics, clinical features, pregnancy outcomes, relapses, effects of exposure to disease-modifying drugs on pregnancy and fetus, and worries about pregnancy decisions were investigated. 85.9 % of females were diagnosed with relapsing-remitting multiple sclerosis. The mean age was 39.0 ± 9.0 years (min 20, max 68). The mean EDSS score was 2.26 ± 1.8. The number of conceptions was inversely correlated with the level of education with significance (p<0.05). Among the concerns related to pregnancy, 31.7 % pertain to disability progression, 14.4 % are associated with relapses, and 7.3 % involve the cessation of treatment. Additionally, 82.3 % of females with MS experienced no relapses during both pregnancy and the postpartum period. Most of the relapses (22.9 %) occurred in the postpartum period. Higher EDSS scores were detected in patients who have higher numbers of pre-MS period pregnancies (p= 0.042; r:0.2591). A similar correlation was found between the total number of pregnancies and higher EDSS levels (p=0.003, r:0.2614). Considering the relationship between EDSS score and the number of pregnancies after MS diagnosis, no significance was found (p = 0.595). The age at first pregnancy did not affect the onset age of MS. Significant positive correlation was found between the age of onset and the total number of pregnancies and pre-MS pregnancies. As the number of pregnancies increased, the disease onset was at a later age (correlation = 0.4258). Presence of pre-MS pregnancies increased the age of onset of MS and caused more disability. The reduction in the number of pregnancies following the diagnosis of MS was related with a consistent hesitancy among patients in this regard.