Pregnancy-Related and Perinatal Outcomes in Women With Multiple Sclerosis
A Nationwide Danish Cross-sectional Study
Abstract
Objective
To investigate differences in pregnancy-related and perinatal outcomes in women with multiple sclerosis (MS) compared with the general population.
Methods
We conducted a cross-sectional study including pregnancies from January 1, 1997, to December 31, 2016, to women registered in the Danish Multiple Sclerosis Registry (the study cohort). Pregnancy-related and perinatal outcomes were compared with a randomly selected subcohort of pregnancies from the general population (the comparison cohort) using logistic regression adjusted for possible confounders.
Results
In total, 2,930 pregnancies were included in the study cohort and 56,958 pregnancies in the comparison cohort. No differences were found in pregnancy-related complications (preeclampsia/gestational diabetes or placenta complications), emergency caesarean section (c-section), instrumental delivery, low Apgar score, stillbirth, preterm birth, or congenital malformations. Elective c-section (odds ratio [OR] 1.89 [95% confidence interval (CI) 1.65–2.16]), induced delivery (OR 1.15 [95% CI 1.01–1.31]), and being born small for gestational age (SGA) (OR 1.29 [95 %CI 1.04–1.60]) had a higher prevalence in the study cohort, whereas the prevalence of signs indicating asphyxia was lower in the study cohort (OR 0.87 [95% CI 0.78–0.97]) relative to the comparison cohort.
Conclusion
We found a higher prevalence of elective c-sections, induced delivery, and infants being SGA among newborns to women with MS, whereas the prevalence of asphyxia was lower in the study cohort. There were no significant differences in severe adverse perinatal outcomes when comparing women with MS and their newborns with those of the general population.
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Information & Authors
Information
Published In
Neurology® Clinical Practice
Volume 11 • Number 4 • August 2021
Pages: 280-290
Copyright
© 2021 American Academy of Neurology.
Publication History
Received: June 19, 2020
Accepted: November 4, 2020
Published online: February 3, 2021
Published in print: August 2021
Disclosure
J.B. Andersen has received travel and congress participation funds from Merck. T.I. Kopp served on scientific advisory board and received speaker honoraria from Novartis. F. Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, Merck, Novartis, Roche, Sanofi Genzyme, and Teva. M. Magyari has served on scientific advisory board for Biogen, Sanofi, Teva, Roche, Novartis, and Merck; has received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, and Genzyme; and has received research support and support for congress participation from Biogen, Genzyme, Teva, Roche, Merck, and Novartis. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Study Funding
No targeted funding reported.
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Cited By
- Recommendations for the Treatment of Multiple Sclerosis in Family Planning, Pregnancy and Lactation in Switzerland: Immunotherapy, Clinical and Translational Neuroscience, 8, 3, (26), (2024).https://doi.org/10.3390/ctn8030026
- Cesarian sections in women with multiple sclerosis: A Canadian prospective pregnancy study, Multiple Sclerosis Journal - Experimental, Translational and Clinical, 10, 4, (2024).https://doi.org/10.1177/20552173241285546
- Children born preterm or small for gestational age to mothers with multiple sclerosis: Do these children have an increased risk of infections in early life?, Multiple Sclerosis Journal, 30, 9, (1176-1184), (2024).https://doi.org/10.1177/13524585241249077
- Pregnancy and reproductive health in women with multiple sclerosis: an update, Current Opinion in Neurology, 37, 3, (202-211), (2024).https://doi.org/10.1097/WCO.0000000000001275
- Patient-centered pregnancy planning in multiple sclerosis: evidence for a new era, Arquivos de Neuro-Psiquiatria, 82, 10, (001-011), (2024).https://doi.org/10.1055/s-0044-1791202
- Neonatal outcomes in women with Multiple Sclerosis – Influence of disease activity: A Danish nationwide cohort study, Multiple Sclerosis and Related Disorders, 85, (105549), (2024).https://doi.org/10.1016/j.msard.2024.105549
- Maternal Multiple Sclerosis and Health Outcomes Among the Children: A Systematic Review, Clinical Epidemiology, Volume 15, (375-389), (2023).https://doi.org/10.2147/CLEP.S392273
- Multiple sclerosis, disease-modifying drugs and risk for adverse perinatal and pregnancy outcomes: Results from a population-based cohort study, Multiple Sclerosis Journal, 29, 6, (731-740), (2023).https://doi.org/10.1177/13524585231161492
- Disease activity and neonatal outcomes after exposure to natalizumab throughout pregnancy, Journal of Neurology, Neurosurgery & Psychiatry, 95, 6, (561-570), (2023).https://doi.org/10.1136/jnnp-2023-332804
- Fertility, pregnancy and childbirth in women with multiple sclerosis: a population-based study from 2018 to 2020, Journal of Neurology, Neurosurgery & Psychiatry, 94, 9, (689-697), (2023).https://doi.org/10.1136/jnnp-2022-330883
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