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Maternal and perinatal outcomes in pregnancies with multiple sclerosis: a case-control study

  • Serenat Eris Yalcin , Yakup Yalcin , And Yavuz , Mehmet Ozgur Akkurt and Mekin Sezik EMAIL logo
Published/Copyright: April 28, 2016

Abstract

Objective:

To assess whether maternal multiple sclerosis (MS) is associated with adverse pregnancy outcomes by determining the clinical course of disease during pregnancy and postpartum throughout a 10-year-period in a single tertiary center.

Methods:

We conducted a case-control study that included pregnancies with a definitive diagnosis of MS (n=43), matched with 100 healthy pregnant women with similar characteristics. Maternal and perinatal data were retrieved from hospital files. Groups were compared with the Mann-Whitney and χ2 tests. Logistic regression models were constructed to determine independent effects.

Results:

Maternal demographic and baseline laboratory data were similar across the groups. Rates of preterm delivery, fetal growth restriction, preeclampsia, gestational diabetes, stillbirth, cesarean delivery, congenital malformation, and 5-min Apgar score were comparable (P>0.05 for all). General anesthesia during cesarean delivery (96% vs. 39%, P=0.002), urinary tract infection (UTI) (12% vs. 3%, P=0.04), low 1-min Apgar score (21% vs. 9%, P=0.04), and nonbreastfeeding (33% vs. 2%, P=0.001) were more frequent in women with MS. The low 1-min Apgar score and breastfeeding rates were independent of general anesthesia and UTI in regression models.

Conclusion:

MS during pregnancy was not associated with adverse maternal and perinatal outcomes except UTI, low 1-min Apgar scores, and decreased breastfeeding rates.

References

[1] Van der Kop ML, Pearce MS, Dahlgren L, Synnes A, Sadovnick D, Sayao AL, et al. Neonatal and delivery outcomes in women with multiple sclerosis. Ann Neurol. 2011;70:41–50.10.1002/ana.22483Search in Google Scholar PubMed PubMed Central

[2] Confavreux C, Hutchinson M, Hours MM, Cortinovis-Tourniaire P, Moreau T. Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. New Engl J Med. 1998;339:285–91.10.1056/NEJM199807303390501Search in Google Scholar PubMed

[3] Buraga I, Popovici RE. Multiple sclerosis and pregnancy: current considerations. ScientificWorldJournal. 2014;2014:513160.10.1155/2014/513160Search in Google Scholar PubMed PubMed Central

[4] Fernández Liguori N, Klajn D, Acion L, Cáceres F, Calle A, Carrá A, et al. Epidemiological characteristics of pregnancy, delivery, and birth outcome in women with multiple sclerosis in Argentina (EMEMAR study). Mult Scler. 2009;15:555–62.10.1177/1352458509102366Search in Google Scholar PubMed

[5] Hellwig K, Haghikia A, Rockhoff M, Gold R. Multiple sclerosis and pregnancy: experience from a nationwide database in Germany. Ther Adv Neurol Disord. 2012;5:247–53.10.1177/1756285612453192Search in Google Scholar PubMed PubMed Central

[6] Dahl J, Myhr KM, Daltveit AK, Hoff JM, Gilhus NE. Pregnancy, delivery, and birth outcome in women with multiple sclerosis. Neurology. 2005;65:1961–3.10.1212/01.wnl.0000188898.02018.95Search in Google Scholar PubMed

[7] Chen YH, Lin HL, Lin HC. Does multiple sclerosis increase risk of adverse pregnancy outcomes? A population-based study. Mult Scler. 2009;15:606–12.10.1177/1352458508101937Search in Google Scholar PubMed

[8] Pozzilli C, Pugliatti M; ParadigMS Group. An overview of pregnancy-related issues in patients with multiple sclerosis. Eur J Neurol. 2015;2:34–9.10.1111/ene.12797Search in Google Scholar PubMed

[9] Altintas A, Najar B, Gozubatik-Celik G, Menku SF. Pregnancy data in a Turkish Multiple Sclerosis Population. Eur Neurol. 2015;74:296–302.10.1159/000441450Search in Google Scholar PubMed

[10] Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69:292–302.10.1002/ana.22366Search in Google Scholar PubMed PubMed Central

[11] Damek DM, Shuster EA. Pregnancy and multiple sclerosis. Mayo Clin Proc. 1997;72:977–89.10.1016/S0025-6196(11)63371-5Search in Google Scholar

[12] Trooster WJ, Teelken AW, Gerrits PO, Lijnema TH, Loof JG, Minderhoud JM, et al. The effect of gonadectomy on the clinical course of chronic experimental allergic encephalomyelitis. Clin Neurol Neurosurg. 1996;98:222–6.10.1016/0303-8467(96)00027-3Search in Google Scholar

[13] Trooster WJ, Teelken AW, Kampinga J, Loof JG, Nieuwenhuis P, Minderhoud JM. Suppression of acute experimental allergic encephalomyelitis by the synthetic sex hormone 17-alpha-ethinylestradiol: an immunological study in the Lewis rat. Int Arch Allergy Immunol. 1993;102:133–40.10.1159/000236563Search in Google Scholar PubMed

[14] Saito I. Structure of IL-10 and its role in autoimmune exocrinopathy. Crit Rev Immunol. 2000;20:153–65.10.1615/CritRevImmunol.v20.i2.40Search in Google Scholar

[15] Mueller BA, Zhang J, Critchlow CW. Birth outcomes and need for hospitalization after delivery among women with multiple sclerosis. Am J Obstet Gynecol. 2002;186:446–52.10.1067/mob.2002.120502Search in Google Scholar PubMed

[16] Ferrero S, Pretta S, Ragni N. Multiple sclerosis: management issues during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2004;115:3–9.10.1016/j.ejogrb.2003.10.020Search in Google Scholar PubMed

[17] Bennett KA. Pregnancy and multiple sclerosis. Clin Obstet Gynecol. 2005;48:38–47.10.1097/01.grf.0000153881.20014.86Search in Google Scholar PubMed

[18] Pastò L, Portaccio E, Ghezzi A, Hakiki B, Giannini M, Razzolini L, et al. Epidural analgesia and cesarean delivery in multiple sclerosis post-partum relapses: the Italian cohort study. BMC Neurol. 2012;12:165.10.1186/1471-2377-12-165Search in Google Scholar PubMed PubMed Central

[19] Malhotra D, Alex M, Bengtsson J. Anesthetic management of pregnant patient with multiple sclerosis. Internet J Anesthesiol. 2010;28:1–4.10.5580/1488Search in Google Scholar

[20] Vukusic S, Hutchinson M, Hours M, Moreau T, Cortinovis-Tourniaire P, Adeleine P, et al. The Pregnancy In Multiple Sclerosis Group; Pregnancy In Multiple Sclerosis Group. Pregnancy and multiple sclerosis (the PRIMS study): clinical predictors of post-partum relapse. Brain. 2004;127:1353–60.10.1093/brain/awh152Search in Google Scholar PubMed

[21] Coyle PK, Christie S, Fodor P, Fuchs K, Giesser B, Gutierrez A, et al. Women Neurologists MS Initiative. Multiple sclerosis gender issues: clinical practices of women neurologists. Mult Scler. 2004;10:582–8.10.1191/1352458504ms1083oaSearch in Google Scholar PubMed

[22] Achiron A, Kishner I, Dolev M, Stern Y, Dulitzky M, Schiff E, et al. Effect of intravenous immunoglobulin treatment on pregnancy and postpartum-related relapses in multiple sclerosis. J Neurol. 2004;251:1133–7.10.1007/s00415-004-0495-zSearch in Google Scholar PubMed

[23] Haas J, Hommes OR. A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis. Mult Scler. 2007;13:900–8.10.1177/1352458506075654Search in Google Scholar PubMed

[24] Boskovic R, Wide R, Wolpin J, Bauer DJ, Koren G. The reproductive effects of beta interferon therapy in pregnancy: a longitudinal cohort. Neurology. 2005;65:807–11.10.1212/01.wnl.0000180575.77021.c4Search in Google Scholar PubMed

[25] Patti F, Cavallaro T, Lo Fermo S, Nicoletti A, Cimino V, Vecchio R, et al. Is in utero early-exposure to interferon beta a risk factor for pregnancy outcomes in multiple sclerosis? J Neurol. 2008;255:1250–3.10.1007/s00415-008-0909-4Search in Google Scholar PubMed

[26] De Las Heras V, De Andrés C, Téllez N, Tintoré M; EMPATIE Study Group. Pregnancy in multiple sclerosis patients treated with immunomodulators prior to or during part of the pregnancy: a descriptive study in the Spanish population. Mult Scler. 2007;13:981–4.10.1177/1352458507077896Search in Google Scholar PubMed

[27] Jalkanen A, Kauko T, Turpeinen U, Hämäläinen E, Airas L. Multiple sclerosis and vitamin D during pregnancy and lactation. Acta Neurol Scand. 2015;131:64–7.10.1111/ane.12306Search in Google Scholar PubMed

[28] Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59:881–6.10.2310/JIM.0b013e31821b8755Search in Google Scholar PubMed PubMed Central

[29] Arnson Y, Amital H, Shoenfeld Y. Vitamin D and autoimmunity: new aetiological and therapeutic considerations. Ann Rheum Dis. 2007;66:1137–42.10.1136/ard.2007.069831Search in Google Scholar PubMed PubMed Central

[30] Munger KL, Zhang SM, O’Reilly E, Hernán MA, Olek MJ, Willett WC, et al. Vitamin D intake and incidence of multiple sclerosis. Neurology. 2004;62:60–5.10.1212/01.WNL.0000101723.79681.38Search in Google Scholar PubMed

[31] Arasil T, Uysal AR, Idil A, Agbaht K, Gullu S, Yalcin P, et al. Vitamin D status of women living in Ankara. Turk Jem. 2010;14:39–43.Search in Google Scholar

[32] Aydogmus S, Kelekci S, Aydogmus H, Eriş S, Desdicioğlu R, Yilmaz B, et al. High prevalence of vitamin D deficiency among pregnant women in a Turkish population and impact on perinatal outcomes. J Matern Fetal Neonatal Med. 2015;28:1828–32.10.3109/14767058.2014.969235Search in Google Scholar PubMed

  1. The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2016-2-19
Accepted: 2016-3-31
Published Online: 2016-4-28
Published in Print: 2017-5-24

©2017 Walter de Gruyter GmbH, Berlin/Boston

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