Annual relapse rate 0.39 before pregnancy, dropped during pregnancy, rebounded by four to six months
FRIDAY, March 8, 2019 (HealthDay News) — Women with multiple sclerosis (MS) seem not to suffer from pregnancy-related relapses in the early postpartum period, according to a study scheduled for presentation at the upcoming annual meeting of the American Academy of Neurology, to be held from May 4 to 10 in Philadelphia.
Annette Langer-Gould, M.D., Ph.D., from Kaiser Permanente Southern in Pasadena, California, and colleagues prospectively collected data to examine the risk for postpartum relapse for 466 pregnancies among 375 women with MS.
The researchers found that in the year prior to conception, 38.0 percent of women were not on any treatment, 14.6 percent had clinically isolated syndrome, and 8.4 percent experienced relapse during pregnancy. Overall, 26.4 percent relapsed in the postpartum year. Eighty-seven percent breastfed, including 35 percent who breastfed exclusively. A total of 41.2 percent resumed disease-modifying treatments (DMTs). There was a decrease in annualized relapse rate (ARR) from 0.39 prepregnancy to 0.07 to 0.14 during pregnancy; no rebound disease activity was seen in the postpartum period. In the first three postpartum months, ARR was slightly suppressed (0.27), returning to prepregnancy rates at four to six months (0.37). The risk for postpartum relapse was reduced by exclusive breastfeeding (adjusted hazard ratio, 0.58); resuming modestly effective DMTs had no impact.
“Women with MS today can have children, breastfeed, and resume their treatment without experiencing an increased risk of relapses during the postpartum period,” Langer-Gould said in a statement.
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