Study Shows Pregnant Women With MS Don't Have Higher Risk of Pregnancy Complications
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Reviewed By Louise Chang, MD
Nov. 18, 2009 -- Pregnant women with multiple sclerosis (MS) are only a little more likely to deliver babies by cesarean section than women who don't have the neurological disorder, a new study shows.
The study also shows that women with MS are no more likely to have other problems with pregnancy, such as high blood pressure and premature rupture of membranes, than women in the general population, says Victoria Kelly, MD, and colleagues from Stanford University School of Medicine.
Their study is published in the November online edition of Neurology.
"These results are reassuring for women with MS," says study co-researcher Eliza Chakravarty, MD, MS. "Women and their doctors have been uncertain about the effect of MS on pregnancy, and some women have chosen to delay or even avoid pregnancy due to the uncertainty."
Previous studies on MS and pregnancy have focused on the impact of pregnancy on disease activity, the researchers say in a news release. But Chakravarty says her team found that women with MS "did not have an increased risk of most pregnancy complications."
Multiple Sclerosis and Pregnancy
The researchers analyzed data on 18.8 million deliveries in 38 states, with about 10,000 of those occurring in women with MS.
The researchers also looked at women who had diabetes before becoming pregnant and found that they had higher rates of complications than women with MS.
A higher percentage of women with MS (2.7%) compared to the general population of women (1.9%) were found to have a fetus with intrauterine growth restriction, or have weight less than the 10th percentile for the gestational age.
Forty-two percent of women with MS had C-sections, compared with 33% of pregnant women in the general population. The increased risk for cesarean delivery was 30% higher for women with MS and 50% higher for women with epilepsy.
"Multiple sclerosis and epilepsy are two chronic neurologic disorders affecting women of childbearing age," according to Kelly and colleagues. "Because of disease complexity, concomitant medications and potential for disease exacerbation, women with these conditions may delay or avoid pregnancy."
"Despite significant advances in management of these chronic diseases, many patients and physicians remain uncertain of the potential risks associated with pregnancy and delivery," the researchers write. "Our results demonstrate that pregnancy outcomes for women with MS are generally reassuring."
The researchers say future research should examine medications and other variables that lead to cesarean delivery and intrauterine growth restriction.
Gary M. Franklin, MD, MPH, of the University of Washington, and Helen Tremlett, PhD, of the University of British Columbia, write in an accompanying editorial that the new study is "a welcome addition" to previous research, providing "critical information" for doctors and women who are pregnant or are considering pregnancy who have MS or epilepsy.
They say the article by Kelly and colleagues illuminates the question of risks of pregnancy problems for women with MS and epilepsy.
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SOURCES: News release, American Academy of Neurology.
Kelly, V. Neurology, Nov. 18, 2009.
Franklin, G. Neurology, Nov. 18, 2009.
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