Pregnancy-related and Perinatal Outcomes in Women with MS 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 sub-cohort 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 (pre-eclampsia/gestational diabetes or placenta complications), emergency caesarian-section (c-section), instrumental delivery, low Apgar score, stillbirth, pre-term 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 (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 to those of the general population.