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Better prognosis of multiple sclerosis in patients who experienced a full-term pregnancy
Kiandokht Keyhanian1, Vahid Davoudi, Masoud Etemadifar
1Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. kiandokht.keyhanian@gmail.com
Objective:
We conducted a longitudinal prospective study to evaluate the long-term effect of pregnancy on the progression of multiple sclerosis (MS).
Method:
Parous female MS patients were extracted from the database of Isfahan multiple sclerosis society (IMSS). Through comparing the annual relapsing rate during a mean of 4 years before pregnancy versus a mean of 6 years after delivery, MS progression influenced by the pregnancy was analyzed.
Result:
102 female patients were included in our study. The mean annual relapsing rate 4 years prior to pregnancy was significantly higher than at the subsequent 6 years after delivery (1.06 vs. 0.45, p < 0.001). In addition, the annual relapsing rate in years prior to pregnancy was significantly higher than each trimester of gestation (p < 0.001). Furthermore, there was a 2.2-fold increased risk of having a relapse in individuals who had experienced more relapses prior to pregnancy, and a 0.8-fold decreased in the risk of having more relapses with older age at the onset of MS.
Conclusion:
Although the course of MS was deteriorated 3 months after delivery, it was not statistically significant comparing annual relapsing rates during the years prior to pregnancy. Moreover, the rate of disease progression slowed down in the 6-year period monitored after delivery.
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