Successive Pregnancies Not Associated With MS Relapse Rate

Among study participants, relapse rate actually decreased from the first to second pregnancy.

Women with multiple sclerosis (MS) who have successive pregnancies can expect to face the same or lower level of disease activity after each delivery, new data shows.

The findings, published in Neurology, may help restore confidence in women with MS who experienced relapse after an initial pregnancy.

Pregnancy in women with MS is typically associated with a reduction in annualized relapse rate; however disease activity is known to increase in the postpartum period.

In order to explore the rate of MS disease activity in patients with multiple pregnancies, Amandine Benoit, MD, of Hôpital Neurologique Pierre Wertheimer in Bron, France, and colleagues analyzed relapse data from 93 women with MS who had at least 2 successive pregnancies between 1993 and 2013. They also included a control cohort of 68 women with MS who only had 1 pregnancy during the 10-year study period.

In total, 7.6% of participants experienced a relapse after both pregnancies. When analyzing individual pregnancies, 31.2% experience relapse after the first pregnancy and 23.7% after the second pregnancy. Notably, risk of relapse after the second pregnancy was not found to be associated with relapse rate during the pre-pregnancy year (OR 1.52 [0.57–4.05]), during pregnancy (OR 1.57 [0.52–4.79]), or relapse incidence after the first pregnancy (OR 0.86 [0.29–2.50]).

Reflecting on the data, the researchers concluded that there is no correlation between successive pregnancies and MS disease activity. Physicians should therefore counsel MS patients similarly through their first and successive pregnancies, they advised.

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Benoit A, Durand-dubief F, Amato MP, et al. History of multiple sclerosis in 2 successive pregnancies: A French and Italian cohort. Neurology. 2016; doi:10.1212/WNL.0000000000003036.