Pregnancy in women with MS: Impact on long-term disability accrual in a nationwide Danish Cohort

• Published in: Multiple sclerosis Vol. 28; no. 8; p. 1239
• Main Authors: Andersen, Johanna Balslev, Wandall-Holm, Malthe Faurschou, Andersen, Per Kragh, Sellebjerg, Finn, Magyari, Melinda
• Format: Journal Article
• Language: English
• Published: England 01.07.2022
• Subjects: Cohort Studies; Denmark - epidemiology; Disability Evaluation; Disabled Persons; Disease Progression; Female; Humans; Multiple Sclerosis - diagnosis; Multiple Sclerosis - epidemiology; Multiple Sclerosis, Relapsing-Remitting - diagnosis; Pregnancy; Denmark; disability accumulation; Multiple sclerosis; pregnancy
• ISSN: 1477-0970
• DOI: 10.1177/13524585211057767

Pregnancy is considered to influence the disease course in women with multiple sclerosis (MS). The aim of this study was to investigate the effect of pregnancy on long-term disability accrual in women with MS. The Danish Multiple Sclerosis Registry (DMSR) was used to identify women diagnosed with clinically isolated syndrome or relapsing-remitting MS. Cox models with pregnancy as a time-dependent exposure and propensity score (PS) models were used to evaluate time to reach confirmed Expanded Disability Status Scale (EDSS) score of 4 and 6. A total of 425 women became parous and 840 remained nulliparous. When including pregnancy as a time-dependent exposure, a non-significant association with time to reach EDSS 4 (hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.61-1.20) and EDSS 6 (HR 0.70, 95% CI 0.40-1.20) was found. Correspondingly, the PS model showed no association with pregnancy on time to reach EDSS 4 (HR 0.85, 95% CI 0.56-1.28). This study concludes that pregnancy does not affect long-term disability accumulation.