SEATTLE, May 9, 2012 - Washington state hospitals, physicians and expectant mothers have teamed up to deliver a dramatic increase in the number of babies born at full term – 39 weeks – instead of earlier in their pregnancies. They did this by rapidly changing established obstetric practices in place for many years. This change came about because of new research demonstrating the short- and long-term hazards of delivery prior to 39 weeks.
Considering that multiple sclerosis (MS) affects primarily women of childbearing age, it comes as no surprise that for many patients MS and pregnancy often occur together. The issues to consider when discussing pregnancy and MS include:
- How pregnancy affects MS
- How MS affects pregnancy
- How MS treatment should be managed throughout pregnancy
The Pregnancy in MS (PRIMS) study of 254 patients revealed that pregnancy is generally protective against MS relapses, in particular during the third trimester. In contrast, the same study found a rebound of relapses during three months post delivery, with 30 percent of women experiencing a relapse within three months after delivery. Several strategies have been proposed to avert the risk of postpartum relapse, including the use of prophylactic IVIG or corticosteroids. More recently, exclusive breast-feeding has been found to offer some protection against postpartum MS activity; however, this finding was disputed in a subsequent study.
There is no evidence ...