MS Progression Apparently Not Affected by Number of Pregnancies, Study Reports

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New long-term research indicates that having multiple children does not lessen or otherwise impact disability in women with multiple sclerosis (MS). The study, titled Offspring Number Does Not Influence Reaching the Disability’s Milestones in Multiple Sclerosis: A Seven-Year Follow-Up Study, was published in The International Journal of Molecular Sciences.

Scientists have conflicting opinions about whether or how pregnancy affects MS symptoms. MS, an autoimmune disorder in which the immune system attacks the myelin that wraps around nerve cells, occurs more frequently in women than in men, and often in women of child-bearing age, suggesting that hormonal differences could play a role.

To study the impact of pregnancy on MS disability severity, the investigators, led by Emanuele D’Amico of the Department of Neurology, University of Catania, Italy, assessed disability progression in women with relapsing-remitting MS (RRMS), who had one or more children following their MS onset. The team divided a total of 86 women into two groups, 56 with one pregnancy and 30 with more than one, and followed them for at least seven years (until December 2007).

The researchers collected data on age at the first pregnancy, amount of time from MS onset to first pregnancy, type of delivery, birth weight, breastfeeding habits, and childhood medical problems. They measured MS disability using a standard method known as expanded disability status scale (EDSS).

Overall, no statistically meaningful differences in the onset of MS-related disability were found between the two groups, suggesting that the number of offspring does not impact disability status. There was, however, a non-statistically significant trend indicating that women with more than one child took a longer time to reach an EDSS disability score of 4 compared to women who had only one child. Because the result was not supported by statistics, more research is needed to determine whether the number of children has an effect on MS-related disability in women.

The investigators concluded, “Our results suggest that experiencing more than one pregnancy could not convey a different clinical outcome in [women with MS]. Further research is needed to confirm our results.”  Such research is of increasing importance, they added, because “[p]regnancy-related issues are not related only to the potential role of pregnancy on disease re-activation after delivery, but they are more and more depending on drug treatments. A number of disease-modifying drugs (DMDs) are available and other are under development to treat RR forms of MS. None of these agents is approved for use in pregnancy.”

Further studies concerning hormonal effects on MS and regarding pregnancy’s impact on MS progression are needed, but based on this work, no strong support exists for a protective effect of pregnancy in MS.


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