Multiple sclerosis and pregnancy: maternal considerations

Multiple sclerosis (MS) is the most commonly acquired neurological disorder affecting young adults of reproductive age with approximately a 3:1 female-to-male ratio. Pregnancy is not contraindicated in MS but remains to be an issue that raises many questions. Although relapse rates tend to increase in the first 3 months postpartum, pregnancy does not seem to be a detriment to the long-term progression of MS and has a protective effect on reducing relapses, especially during the third trimester. MS does not appear to affect fertility or increase the risk of congenital anomalies or pregnancy complications. There has been some evidence that maternal treatment with β interferons, the most commonly used disease-modifying therapies in MS, may cause adverse reproductive outcomes, prompting the US FDA to issue warnings about their use at conception and during pregnancy.