Multiple sclerosis and pregnancy: pregnancy, delivery and birth outcome in woman with multiple sclerosis

Abstract

This study provides information regarding birth-giving in women with multiple sclerosis (MS). MS is a common disease in the western world and causes disability in young adults and, like most immune mediated diseases, affects women more commonly than men. The number of births given by women with MS has increased during the last 30 years, and clinicians often encounter these women’s concerns about pregnancyrelated issues. There are a few studies on the possible effects of MS on the pregnancy and the newborn, but so far no serious adverse effects have been shown. (Mueller et al. 2002;Poser & Poser 1983;Worthington et al. 1994) However, a diagnosis of MS is linked to more frequent operative deliveries. (Davis & Maslow 1992) We have evaluated the influence of MS on pregnancy, delivery and birth outcome in a large historical cohort. Our study illustrated an overall good outcome for pregnancy and birth in MS women, with no increase in adverse birth effects. However, a diagnosis of MS reduced neonatal birth weight. This was not due to an increased smoking rate among pregnant MS women. MS also increased the duration of the second stage of labor and increased the need for induction and operative intervention during birth. The increased rate of planned caesarean section might be justified, since we found that forceps and vacuum extraction occurred with high frequency despite the increased planned caesarean section rate in MS women compared to the references. Our results indicate that health professionals should discuss potential problems and their possible importance for delivery with each pregnant MS woman.