Pregnancy Worsens Symptoms in MS Patients, Study Finds

Pregnancy Worsens Symptoms in MS Patients, Study Finds

Pregnancy, including successful delivery or miscarriage, worsens symptoms of multiple sclerosis (MS), as well as onset of the disease, a retrospective study shows.

Researchers found the same effect of pregnancy on neuromyelitis optica spectrum disorders (NMOSD), an inflammatory disorder of the central nervous system characterized by demyelination and damage of nerve fibers, especially in the eyes and spinal cord.

The study reporting these findings, “Influences of pregnancy on neuromyelitis optica spectrum disorders and multiples sclerosis,” was published in the journal Multiple Sclerosis and Related Disorders.

Women of childbearing age are the most prevalent group of patients with MS. Previous studies have shown  that the frequency of symptoms’ worsening (relapses) in MS patients decreases during pregnancy, especially in the third trimester, but increases during the first trimester after birth.

In this study, Chinese researchers further investigated the impact of pregnancy on MS, mainly on relapse rate and disease onset (when one first experiences disease symptoms).

The retrospective study analyzed 170 MS women admitted to the Beijing Tiantan Hospital, Capital Medical University, Beijing, China. The annualized relapse rate (ARR) was determined by the number of pregnancy-related events during pregnancy (each trimester), or within one year after delivery/miscarriage (for four trimesters). Events before pregnancy also were considered.

Of the 170 MS women enrolled in the study, 128 (75.3%) became pregnant, resulting in 134 deliveries and 105 miscarriages.

Interestingly, researchers found that the age at first pregnancy (mean of 25.9 years) was significantly lower than that at MS symptom onset (mean age of 27.9), suggesting that pregnancy precedes the appearance of disease symptoms.

Researchers counted 376 relapses in MS patients who were pregnant at some point in their life, 64 (17%) of which were pregnancy-related relapses. Among those, five happened during pregnancy and 59 within one year after delivery/miscarriage.

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The ARR determined during the first and fourth semesters postpartum/postabortal periods was significantly higher than during pregnancy, suggesting that pregnancy, and possibly delivery/miscarriage, may contribute to worsening MS symptoms.

Importantly, the team found no correlation between the number of pregnancy-related relapses and MS severity.

Overall, the results of the study suggest an increased onset of symptoms — and worsening of those symptoms — in MS patients who became pregnant. Also, both delivery and miscarriage had a negative impact on MS progression.

Similar results were seen in patients with NMOSD.

Changes in hormone levels and in the immune system’s function during pregnancy may be behind the findings of this study, but researchers recommend further studies to confirm this theory.

“Taken together, this large retrospective study corroborated the results of other studies that elucidated a high relapse rate in the postpartum/postabortal period in NMOSD and MS,” researchers concluded.

14 comments

  1. Mary Ann Cincinnati says:

    I felt great during my first pregnancy except feeling nauseous during my first trimester. It was when my daughter was 6-9 months old that I had my first attack. I couldn’t move my left leg.

  2. itasara says:

    This is a surprising finding. I read articles a few years ago that pregnancy tended to protect or diminish the effect of MS because of the production of estriol ( ?); There was research on this to see if the hormone could be combined with Copaxone as a treatment, but I don’t know that it was successful. I had no idea during my pregnancy years that eventually I would be diagnosed with MS when I was 57. From age 28 to 35 I had 5 successful pregnancies.. So for whatever reason I don’t know that I had any symptoms. ( one of my children at age 20 was diagnoses with MS 3 years before me-it was a shock to hear her diagnosis and a bigger shock later on when I was diagnosed.!) Even though I was diagnosed after one major symptoms (transverse myelitis) at age 57, I don’t doubt I probably had MS for a long time before that, but I really had no idea!

  3. Brooke says:

    I have had 2 children and I was diagnosed with MS 6 months postpartum from my second child, I was 39 years old. I did have some MS -like symptoms during the last trimester of my first pregnancy (in retrospect) but nothing quite like the symptoms after my second child. I had a very heavy right leg.

  4. Lady Jane says:

    My sister had a baby in 2010. Healthy pregnancy and birth but her MS symptoms reappeared within 4 yrs with a VENGEANCE. Watching her go from a using a cane in 2015-16, to a walker, to a scooter in 2017 to full time huge wheelchair in 2018 has been excruciatingly painful. She is not able to see or speak well and needs intensive daily help with bathroom, eating. If you want to play Russian roulette with your health that’s your business but think about it when doctor shopping and being told what you want to hear. Also make sure you are marrying someone who really loved YOU and not the idea of having a kid, possibly, without you. Also, be really sure you aren’t drinking, eating foods that cause inflammation or have a personality prone to stress or difficulty dealing with stress, diet, exercise. Be sure your extended family is in fact because they will be your support system if you get worse. Even under best scenarios, it’s been my experience that unless you are prepared to give your life to bring a child into the world- don’t get pregnant. Primary Progressive MS is like gradually pouring concrete into your body, little by little you lose. Ability to stand, walk, see, talk, think or process, have energy to do anything.

  5. Dorothy Kane says:

    I had a wonderful, healthy pregnancy and then had my first symptoms of MS right after I gave birth to my son (my only pregnancy) in 1981. It was optic neuritis. Over the years after that I had small relapses and was finally diagnosed in 1998 after going to my family doctor, then a neurologist who sent me to a cardiologist who sent me back to the neurologist who finally ordered an MRI. I’ve always believed that MS was dormant in my body until I went through the physical trauma of giving birth. I had a C-section, but other women I’ve spoken with who’ve had the same MS-onset experience had vaginal births.

  6. Debra Hoffstatter says:

    I am not convinced that pregnancy has any impact on developing or worsening MS symptoms or with progression of the disease

  7. Tina says:

    I was diagnosed with MS in 1977. I had one bad attack that led to a wheelchair then immediately out (with ACTH treatment). I got pregnant in ’82 and then again in ’92. Both pregnancies went very well and I breastfed for 3 and 6 years. While pregnant and breastfeeding, I was great but after stopping I’ve gone slowly downhill. It’s now 42 years since diagnosis. I walk carefully with a walker and use a scooter.

  8. pat Schoen says:

    It is obvious that hormonal differences do make a difference, but as all other symptoms, the range and severity are radically different from patient to patient, regardless of gender.
    So many lines of research and trials have promised answers or at least some help for MS patients. the truth is there has been no real breakthrough there are medicines that woe for a while and then the side effects render them ineffective.
    Why has the necessary funding been places into MS research?
    There is no answer to this questions and those of us who have loved one s with Ms are forced to watch with little or no hope that any cure is viable in the immediate future.
    Patricia Schoen

  9. Sarah says:

    I’m a 28 year old woman who was offically diagnosed with MS this past September; however, I’ve had symptoms since I was 17 years old.

    Fear and lack of funds prevented my parents from talking to doctors, and a busy life stopped me as I got older.

    It wasn’t until I woke up one day entirely unable to walk or even hold my head up that my husband rushed me to the ER.

    They quickly made the diagnosis after just one MRI. However they informed me that I have multiple locations in my brain that show permanant damage, likely from the decade of not receiving care for my disease.

    At 28, I’ve been pregnant six times. Two ended in a miscarriage, one 6 weeks and the other at 12 weeks. Two ended in a stillbirth at 37 weeks and then 24 weeks. And I have two living children.

    After reading articles like this one, I can’t help but wonder if my MS played a role in the loss of my babies…

    I will definitely be speaking to my doctors about this very soon.

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