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Women with multiple sclerosis can safely become pregnant if their condition is under control. This has been reinforced by the evidence gathered by a new research.

Women with Multiple Sclerosis can safely become pregnant if their condition is under control

According to Dr. Yara D. Fragoso, a neurologist at the Universidade Metropolitana de Santos in Brazil, and the senior researcher on the new study, the women suffering from multiple sclerosis can think of having a child just like any other woman. The new review has been based on conclusions drawn from over 22 international studies conducted since 1980s and covering more than 13,000 women. The findings suggest that neither does multiple sclerosis have a negative affect on the pregnancy, nor does pregnancy cause any adverse affect on the course of the disease pattern in the long term.

In fact, most of the women suffering from multiple sclerosis have reported an improvement in their symptoms during the pregnancy. This could be because of the natural reduction of the activity of the immune system and the rise in the levels of anti inflammatory hormones, like corticosteroids, during the course of pregnancy.

Women have reported a flaring up of their symptoms post pregnancy but they are not severe enough to increase long term risk of disability.

The possibility of miscarriage, preterm birth, babies with a low birth weight or with congenital defects, which has been associated with multiple sclerosis in the past, has not been found to be true.

Various chemical changes brought about by pregnancy reduce the symptoms of multiple sclerosis

Multiple sclerosis is an auto immune disease in which the immune system of a person starts attacking one’s own nervous system mistaking it for foreign tissue. It leads to multiple problems related to nerves like vision problems, numbness, muscle weakness and difficulty in coordination and balancing. The symptoms typically wax and wane. Earlier, women suffering from multiple sclerosis used to avoid getting pregnant out of the fear that it will worsen their disease. However, now it has been found out that various chemical changes brought about by pregnancy reduce the symptoms of multiple sclerosis. A hormone, estriol, which is elevated during pregnancy, reduces MRI activity. Some immune chemicals like IL-12 and TNF- alpha are decreased during pregnancy. Similarly, cells releasing interferon- gamma which is said to worsen the symptoms of MS, are also reduced during pregnancy. The regulatory T cells which suppress MS symptoms are said to increase during this period. Therefore, pregnancy actually helps in reducing the symptoms of MS.
However, it is important for women with MS to take their doctor into confidence before planning a pregnancy. This is because they may have to alter the dose of certain medicines or stop them completely before conceiving. Immuno-modulating agents, especially beta interferon, given to control the symptoms of MS may lead to miscarriage. Chemotherapeutic medicines like mitoxantrone are contraindicated in pregnancy as they may cause genital defects.
It has been found that women with MS are more likely to undergo a caesarean section. It may be because the muscular weakness may delay the onset of labor or because the doctors and nurses attending such patients are more apprehensive about the patient. Whatever be the reason, a caesarean section does not in any way effect the course of MS. We can safely conclude that women with MS are as likely as other women to have a healthy pregnancy.

  • Finkelsztejn, JBB Brooks, FM Paschoal Jr, YD Fragoso. What can we really tell women with multiple sclerosis regarding pregnancy? A systematic review and meta-analysis of the literature. BJOG: An International Journal of Obstetrics & Gynaecology. March 15th 2011
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