In a finding that should reassure women with multiple sclerosis (MS) who want to have a baby, new research suggests the disease doesn’t raise the risk of pregnancy complications.

“While previous research has shown there is no higher risk of birth defects for babies born to women with MS, there are still a lot of unknowns around pregnancy and multiple sclerosis. We wanted to find out if women with MS are at risk for a variety of pregnancy complications. We found overall their pregnancies were just as healthy as those of the moms without MS” said study author Dr. Melinda Magyari, from the University of Copenhagen in Denmark.

In the study, researchers compared almost 3,000 pregnant women with multiple sclerosis to nearly 57,000 pregnant women without the autoimmune disease. All of the women gave birth between 1997 and 2016.

There was no difference between the two groups in the risk of several pregnancy complications: preeclampsia, gestational diabetes, placenta complications, emergency cesarean section, instrumental delivery, stillbirth, preterm birth, congenital malformations, or low Apgar score.

An Apgar score is a measure of a newborn’s health — including heart rate, reflexes and muscle tone — conducted immediately after birth.

The study did find that rates of elective cesarean section were higher among women with multiple sclerosis (14%) than among those without MS (8%). After adjusting for other factors — such as a prior C-section or mother’s age — the researchers concluded that women with MS were 89% more likely to have an elective C-section.

“We think the reason more women with multiple sclerosis have babies by elective C-section or induced delivery may have to do with MS-related symptoms such as muscle weakness, spasticity or fatigue that might affect the birth,” Magyari said. “Any of these could make a mom more tired and lead to delivery complications that could prompt the clinician and woman to take extra precautions.”

Other findings were that women with multiple sclerosis were 15% more likely to have an induced delivery than women without MS, and that women with MS were 29% more likely to have babies that were small for their gestational age (3.4% vs. 2.8%).

According to the researchers the multiple sclerosis and general population groups did not differ significantly for:

  • Preeclampsia/gestational diabetes: 0.93 (0.77-1.13).

  • Emergency caesarean delivery: 1.03 (0.90-1.17).

  • Instrumental delivery: 1.13 (0.97-1.31).

  • Low Apgar score: 0.90 (0.56-1.44).

  • Stillbirth: 1.17 (0.68-2.00).

  • Preterm birth: 1.12 (0.95-1.33).

  • Congenital malformations: 1.02 (0.87-1.19).

The multiple sclerosis group had higher odds for:

  • Elective caesarean delivery: 1.89 (1.65-2.16).

  • Induced delivery: 1.15 (1.01-1.31).

  • Small for gestational age: 1.29 (1.04-1.60).

The multiple sclerosis group had lower odds for:

  • Placenta complications: 0.62 (0.40-0.94).

  • Signs indicating asphyxia: 0.87 (0.78-0.97).

Read more: https://cp.neurology.org/content/early/2021/02/03/CPJ.0000000000001035