Women's health and pregnancy in patients with multiple sclerosis.
|Title||Women's health and pregnancy in patients with multiple sclerosis.|
|Publication Type||Journal Article|
|Authors||Wundes A, Bamer AM, Salem R, Warner V, Amtmann D|
Background: Multiple sclerosis (MS) often affects females during reproductive years. Although generally no negative impact on fertility is assumed, only limited data are available. In addition, little is known about family decision-making and medical guidance during pregnancy in this population. We surveyed 172 female MS patients on women’s health and MS issues related to fertility and pregnancy. Objective: To explore women’s health and pregnancy related topics in women with MS. Methods: Self-report cross-sectional survey of MS patients in Washington State. To date, 412 completed questionnaires were received (return rate 94%) and data from 202 questionnaires have been entered (172 females). Results: Data from 172 female MS patients have been analyzed. The women reported irregular menstrual cycles during child-bearing years (20%), diagnosis of endometriosis (13%) and polycystic ovarian syndrome (4%). 121 women had biological children, although most had their children prior to MS diagnosis. 25 women became pregnant after being diagnosed with MS. 60% of these were not on disease-modifying treatment (DMT), the remainder discontinued DMT before conception (20%) or during pregnancy (20%). 12% of these women reported relapses during pregnancy and 57% within 6 months of delivery; 65% breast-fed. MS patients received pregnancy-related information from MS specialists (18%), MS organizations (14%) or primary care physicians (7%). Conclusions: Our preliminary analysis suggests that the non-parity rate is increased in comparison with the national average (30% versus 18%). Whether this is the result of biological factors or choice is unknown. At this point, our data indicate that the rate of fertility-related health issues in women with MS may not be much different than in the general population. In agreement with the literature, the risk of relapse post-delivery is high. Extended periods off DMT due to pregnancy and breast-feeding may compromise optimal MS management. Our study highlights the reciprocal influence between women’s health issues and MS. The definitive data will be presented and discussed.