June 27, 2014

Pregnancy outcomes in women with multiple sclerosis

UBC researchers, Dr. Helen Tremlett and Mia van der Kop reported findings from a retrospective cohort study she conducted using data from the British Columbia MS Clinics’ database and the British Columbia Perinatal Database Registry to determine if there was a difference in pregnancy related outcomes between mothers with MS and mothers without MS.  Dr. Tremlett’s team also looked at whether risk level differed among the mothers with MS group based on clinical factors of MS such as age at MS onset, disease duration, or MS disability.

Funded by the Canadian Institutes of Health Research (CIHR), Dr. Tremlett and Ms. van der Kop linked data from the British Columbia MS Clinics’ database and the BC Perinatal Database Registry and analyzed 432 births to mothers with MS and 2975 births to women without MS from 1998 to 2009 to determine if there was a higher risk of adverse delivery or newborn outcomes in the MS group as compared to the non-MS group. The majority of mothers with MS had relapsing forms of MS, with 18 births to mothers with secondary-progressive MS, and four births to mothers with primary progressive MS. The average age of MS onset was 24 years, and disease duration at the time of delivery was approximately seven years. Most of the mothers with MS had mild disability with 58 births to mothers with an Expanded Disability Status Score (EDSS) of 0, while 49 births were to mothers with moderate to severe disability (EDSS ≥3.5).

Age of MS onset and disease duration had no bearing on the outcomes of pregnancy. Additionally, no significant differences were found in gestational age, birth weight or labour length between babies delivered to mothers with MS as compared to those without MS.

"Our study should provide reassurance to women with MS that their risk of encountering poor neonatal or pregnancy-related outcomes is the same as that of women without MS," said Dr. Helen Tremlett, Canada Research Chair in Neuroepidemiology and MS, at the Vancouver Coastal Health Research Institute, Brain Research Centre, University of British Columbia. "That said, women with a higher level of disability may require closer monitoring during pregnancy. This is something that needs further investigation."