Pregnancy andmultiple sclerosis: alongitudinal study of125remittent patients

Therelationship betweenpregnancy and multiple sclerosis (MS)wasassessed ina clinic-based, prospectively followed, population of125patients witharemittentonsetofMS whohadbeenfollowed fora mean (SD)of10-3(0-1)years. Thirtythreewomen hada totalof49 pregnancies ofwhich32hadbeenfull termand17terminated. Therewas a three-fold increase intherelapse rate peryearduringthefirst threemonths following delivery, comparedwiththe baseline periodofthesame patients [1t62(0*38) vs0*51(0O08) p = 0.05]. During pregnancy itself, therelapse-rate wasnot different from baseline. The overall relapse rateofthepregnancy groupwas lowerthanthatofa control groupwithoutpregnancies after MS onset, butsimilar tothatofpatients whohadchildren after MS onset, butnopregnancy during followup.Pregnancydidnotleadto increased disability. Theseresults confirmthatpostpartumincrease inrelapse rateisthemaineventrelated topregnancyinMS andunderline thedifficultiesofundertaking prospective studies in thisfield.