Mothers with MS symptoms may face longer waits for a diagnosis, study finds
Researchers say caregiving and delayed care-seeking may help explain the trend
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Motherhood is linked to longer diagnostic delays in women with multiple sclerosis.
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Delays are greater for employed or single mothers, and when symptoms begin during the child-bearing years.
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Targeted screening during maternal and pediatric visits may help detect MS earlier.
Women with multiple sclerosis (MS) who have children experience significantly longer waits before receiving a diagnosis than women without children, according to a new U.S. study.
On average, each child was associated with an additional 1.28-year delay in diagnosis. The delay was even longer among women whose symptoms began during their reproductive years and among mothers who were employed.
No similar pattern was observed in men, suggesting “a unique impact of motherhood” and gender-related differences in healthcare access, attention to personal symptoms, or competing caregiving responsibilities, the researchers said.
The study, “Motherhood and diagnostic delay among women with multiple sclerosis,” was published in the Journal of Neurology.
Many women develop MS symptoms during childbearing years
MS is most often diagnosed between the ages of 20 and 50. For many women, this means that the first subtle changes, early symptoms, and ultimately an MS diagnosis may all happen during their childbearing years.
Several factors have been linked with longer times to MS diagnosis. These include having other health conditions, smoking, lower education levels, and belonging to a racial minority group. However, “there is currently a paucity of literature concerning how parenthood affects time to a MS diagnosis,” the researchers wrote.
To explore this question, a team at Harvard Medical School analyzed electronic health records from 140 women and 64 men with MS who had been followed at the Department of Neurology at Beth Israel Deaconess Medical Center.
Among women, symptoms began at an average age of 31.5, and the average age at diagnosis was 34.8. Men developed symptoms at an average age of 33.5 and were diagnosed at 37.4. That means, on average, it took 3.2 years for women, and 3.9 years for men, to receive a diagnosis after symptoms began.
When the team looked specifically at motherhood, they found that women with children experienced significantly longer diagnostic delays than those without children. Each child was associated with about 1.28 additional years before diagnosis. When only biological children were counted, the delay increased to about 1.34 years per child.
Although the pattern was not statistically significant, a similar delay was also seen among women with adopted or stepchildren. This suggests that factors related to pregnancy itself — such as hormone or immune-system changes that might mask early MS symptoms — are unlikely to be the main drivers of these delays.
Instead, the researchers suggested that caregiving demands and the tendency for mothers to prioritize their family’s health over their own may be more likely contributors.
“It is commonly acknowledged that mothers prioritize their children’s and family’s health over their own, potentially delaying healthcare seeking for personal symptoms,” the researchers wrote.
Working and single mothers showed the longest delays
When researchers looked only at the 126 women whose symptoms began between ages 18 and 50, the delay increased to 1.41 years per child. In a smaller group of 61 women whose symptoms began between ages 25 and 35, the delay rose to 1.63 years per child.
The diagnostic delays linked to motherhood were even greater in certain subgroups. Among employed mothers, each child was associated with nearly two additional years before diagnosis. Similarly, among single mothers, each child added about 1.61 years between symptom onset and diagnosis.
These findings suggested that “the additional responsibilities and stress associated with balancing work and family life without a spouse could be hypothesized to contribute to mothers sidelining their own health,” the team wrote.
In contrast, no such delay was seen in fathers compared with men without children.
“Considering that mothers have more healthcare visits than non-mothers due to perinatal care, the current findings suggest that implementing targeted screening for neurological symptoms during both routine maternal check-ups and pediatric visits could help identify early signs of MS and reduce diagnostic delays,” the team concluded.
