No Added Risk of Pregnancy Complications for Women With MS, Study Finds

Women with multiple sclerosis (MS) are not at a higher risk than those without the disease of having pregnancy complications, such as gestational diabetes, requiring an emergency cesarean section (c-section), or having a preterm or stillbirth delivery, according to the results of a new study.

Yet, the study’s findings indicated that women with MS are more likely to deliver babies by elective c-section or induced delivery, and their infants are at a higher risk of being small for their age, compared with new mothers who do not have the disease.

The findings were reported in the study, “Pregnancy-related and Perinatal Outcomes in Women with MS A Nationwide Danish Cross-sectional Study,” published in the journal Neurology Clinical Practice.

While previous studies have found that babies born to mothers with MS are not more likely to have birth defects compared with those born to mothers without the disease, there are still some uncertainties regarding pregnancy outcomes in women with the neurodegenerative disorder.

“Women with multiple sclerosis may be understandably concerned about the risks of pregnancy,” Melinda Magyari, MD, PhD, consultant neurologist at Copenhagen University Hospital in Denmark, and senior author of the study, said in a press release.

“We wanted to find out if women with MS are at risk for a variety of pregnancy complications,” Magyari said.

“We found overall their pregnancies were just as healthy as those of the moms without MS,” she said.

In the study, Magyari and her colleagues compared the clinical outcomes of 2,930 pregnant women with MS with those of 56,958 pregnant women from the general population. All of the women included in the study had given birth between 1997 and 2016 and those with MS were registered in the Danish Multiple Sclerosis Registry.

Analyses showed that, compared with women from the general population, those with MS were not at a higher risk of having pregnancy complications, including gestational diabetes, placenta complications, and pre-eclampsia, or high blood pressure potentially accompanied by organ damage.

Additionally, women with MS were not found to be more likely to require an emergency c-section or instrumental delivery, nor to have a preterm or stillbirth, compared with those from the general population.

Researchers also found that babies born to mothers with MS were not more likely to have congenital malformations or a low Apgar score at birth. The Apgar score reflects a baby’s overall health condition and is calculated based on several parameters, including heart rate, reflexes, and muscle tone immediately after birth.

However, the results showed that women with MS were 89% more likely to have an elective c-section and 15% more likely to have an induced delivery than women without the disease.

“We think the reason more women with MS have babies by elective c-section or induced delivery may have to do with MS-related symptoms such as muscle weakness, spasticity or fatigue that might affect the birth,” said Magyari.

“Any of these could make a mom more tired and lead to delivery complications that could prompt the clinician and woman to take extra precautions,” she added.

The team also found that women with MS were 29% more likely to give birth to babies that were too small for their gestational age, a measure of the weeks from conception.

Yet, they were 13% less likely to deliver babies showing signs of oxygen deprivation, or asphyxia, at birth. According to Magyari, this lower risk of newborn asphyxiation in mothers with MS may be due to the fact that a higher percentage of women with MS had elective c-sections (14% vs. 8% in mothers without MS).

Overall, “there were no significant differences in severe adverse perinatal outcomes [in the time before and after birth] when comparing women with MS and their newborns to those of the general population,” the researchers wrote.

Although the team believes that, in general, women with MS are as likely to have a healthy pregnancy as those without the disease, they acknowledged that their findings were limited by the fact that the mothers’ smoking status, which can have a negative impact on fetal development, was unknown.