Term pregnancies and the clinical characteristics of multiple sclerosis: a population based study
- Sreeram Ramagopalan1,2,
- Irene Yee3,
- Jake Byrnes1,
- Colleen Guimond3,
- George Ebers1,2,
- Dessa Sadovnick3,4
- 1Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- 2Department of Clinical Neurology, University of Oxford, Oxford, UK
- 3Department of Medical Genetics, University of British Columbia, Vancouver, Canada
- 4Faculty of Medicine, Division of Neurology, University of British Columbia, Vancouver, Canada
- Correspondence to Professor D Sadovnick, S-113, Koerner Pavilion, VCHA–UBC Hospital, University of British Columbia, 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada;
Contributors SR and IY analysed the data. SR wrote the first draft of the paper. All authors interpreted the data and edited the manuscript draft.
- Received 26 March 2012
- Revised 17 April 2012
- Accepted 19 April 2012
- Published Online First 23 May 2012
Objective Pregnancy has a well documented effect on relapse risk in multiple sclerosis (MS). Prospective studies have reported a significant decline by two-thirds in the rate of relapses during the third trimester of pregnancy and a significant increase by two-thirds during the first 3 months postpartum. However, it is unclear as to whether there are any long term effects on disability.
Methods Data were collated from clinical records and family histories systematically collected from the University of British Columbia MS Clinic.
Results Clinical and term pregnancy data were available from 2105 female MS patients. MS patients having children after MS onset took the longest time to reach an Expanded Disability Status Scale (EDSS) score of 6 (mean 22.9 years) and patients having children before MS onset were the quickest (mean 13.2 years). However, these effects were not related to term pregnancy and were fully accounted for by age of MS onset.
Conclusions Pregnancy had no effect on the time to reach an EDSS score 6. As MS predominantly affects women of childbearing age, women with MS can be reassured that term pregnancies do not appear to have any long term effects on disability.
Funding This work was funded by the Multiple Sclerosis Society of Canada Scientific Research Foundation and the Wellcome Trust (Grant No 075491/Z/04).
Competing interests None.
Ethics approval Ethics approval was provided by the University of British Columbia.
Provenance and peer review Not commissioned; externally peer reviewed.