MS May Not Flare Post Pregnancy, Study Finds

According to findings from a preliminary study, researchers now believe that multiple sclerosis (MS) may not flare following pregnancy as had long been assumed. The study results will be presented at the American Academy of Neurology’s 71st Annual Meeting in Philadelphia, Pennsylvania, May 4-10, 2019.

Researchers reviewed records from Kaiser Permanente Southern and Northern California databases and identified 466 pregnancies among 375 women with MS from 2008 to 2016. The study investigators analyzed medical records and surveyed the women about treatment, breastfeeding, and relapses.

Among included participants, 38% had not been receiving MS treatment in the year prior to becoming pregnant. At the start of the pregnancy, 15% had clinically isolated syndrome, and 8% experienced a relapse during pregnancy. Conversely, in the year after giving birth, 26% of women experienced a relapse, 87% breastfed, 35% breastfed exclusively, and 41% started taking MS treatment again.

Prior to pregnancy, the annual relapse rate for the participants was 0.39. During pregnancy, the rate fell in the range of 0.07 to 0.014. Researchers noted that disease activity did not recur after birth as demonstrated by a relapse rate of 0.27 in the first 3 months after birth. The researchers remeasured the relapse rate at 4 and 6 months after birth, at which time the rate had returned to pre-pregnancy level, at 0.37.

“These results are exciting as MS is more common among women of childbearing age than in any other group. This shows us that women with MS today can have children, breastfeed, and resume their treatment without experiencing an increased risk of relapses during the postpartum period,” said study author Annette Langer-Gould, MD, PhD, in a statement.

Of note, women who breastfed exclusively were nearly 40% less likely to experience a relapse than women who did not breastfeed. Women who supplemented breast milk with formula within 2 months post delivery were just as likely to relapse as women who did not breastfeed at all. Of the women who breastfed exclusively, 46 out of 167 resumed MS treatment while breastfeeding.

The study authors recommended that future studies look at the subgroup of women who are treated with natalizumab or fingolimod prior to pregnancy, as those who take such medications tend to have a more severe form of MS. Future studies should analyze this subgroup so as to further investigate reported severe relapses related to stopping these specific treatments during pregnancy.

Reference

Good news for women with MS: disease may not worsen after pregnancy after all [press release]. Minneapolis: American Academy of Neurology; February 26, 2019. newswise.com/articles/view/708751/?sc=sphr&xy=10022175. Accessed March 18, 2019.