Obstetric and neonatal outcomes in women with multiple sclerosis: A nationwide matched cohort study in Korea

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system that often affects women of reproductive age. The impact of MS on obstetric and neonatal outcomes remains unclear, particularly in women of advanced maternal age.

We aimed to evaluate obstetric and neonatal outcomes in women with MS using data extracted from the National Health Screening Examination (NHSE) and the National Health Screening Program for Infants and Children (NHSPIC) in Korea.

Women with singleton live births between 2011 and 2020 who underwent the NHSE within 4 years before pregnancy were identified. Women with MS (n = 481) were matched 1:10 to women without MS (n = 4810) based on age and comorbidity indices. Outcomes were compared using multivariate logistic regression considering maternal age.

Women with MS had a higher risk of preterm birth (odds ratio [OR] = 2.50; 95% confidence interval [CI] = 1.38-4.52) and placenta previa (OR = 1.83; 95% CI = 1.05-3.20) compared with controls. The association between MS and preterm birth was particularly pronounced in women of advanced age. Other obstetric outcomes did not differ significantly according to MS status, and neonatal outcomes were similar between the two groups.

Most obstetric and neonatal outcomes were comparable between women with and without MS. However, for pregnant women with MS, age ⩾ 35 years was associated with an increased risk of preterm birth, highlighting the importance of careful prenatal monitoring in this population. Further studies are warranted to elucidate the mechanisms underlying this risk.