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Neurology. 2016 Sep 27;87(13):1360-7. doi: 10.1212/WNL.0000000000003036. Epub 2016 Jul 27.

History of multiple sclerosis in 2 successive pregnancies: A French and Italian cohort.

Author information

1
From the Service de Neurologie A (A.B., F.D.-D., S.R., G.A., L.G., I.I., R.M., C.C., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; Centre des Neurosciences de Lyon (A.B., F.D.-D., S.R., G.A., L.G., I.I., R.M., C.C., S.V.), INSERM 1028 et CNRS UMR5292, Equipe Neuro-oncologie et Neuro-inflammation; Université de Lyon (A.B., F.D.-D., S.R., G.A., L.G., I.I., R.M., C.C., S.V.); Université Lyon 1 et Université de Lyon (A.B., R.C., S.R., R.M., C.C., S.V.), France; Department NEUROFARBA (M.-P.A., E.P.), Section Neurosciences, University of Florence, Italy; Observatoire Français de la Sclérose en Plaques (R.C., C.C., S.V.), Bron, France; Departments of Medical Sciences (M.-G.M.) and Public Health, Clinical and Molecular Medicine (E.C.), University of Cagliari; Hospital of Gallarate (A.G., P.A.), Varese; Department of Basic Medical Sciences (M.T., M.S.), Neurosciences and Sense Organs, University of Bari, Italy; Fondation Eugène Devic EDMUS contre la Sclérose en Plaques (R.M., C.C., S.V.), Bron; and Centre des Neurosciences de Lyon (R.M., C.C., S.V.), INSERM 1028 et CNRS UMR5292, Equipe Neuro-oncologie et Neuro-inflammation, France.
2
From the Service de Neurologie A (A.B., F.D.-D., S.R., G.A., L.G., I.I., R.M., C.C., S.V.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon/Bron; Centre des Neurosciences de Lyon (A.B., F.D.-D., S.R., G.A., L.G., I.I., R.M., C.C., S.V.), INSERM 1028 et CNRS UMR5292, Equipe Neuro-oncologie et Neuro-inflammation; Université de Lyon (A.B., F.D.-D., S.R., G.A., L.G., I.I., R.M., C.C., S.V.); Université Lyon 1 et Université de Lyon (A.B., R.C., S.R., R.M., C.C., S.V.), France; Department NEUROFARBA (M.-P.A., E.P.), Section Neurosciences, University of Florence, Italy; Observatoire Français de la Sclérose en Plaques (R.C., C.C., S.V.), Bron, France; Departments of Medical Sciences (M.-G.M.) and Public Health, Clinical and Molecular Medicine (E.C.), University of Cagliari; Hospital of Gallarate (A.G., P.A.), Varese; Department of Basic Medical Sciences (M.T., M.S.), Neurosciences and Sense Organs, University of Bari, Italy; Fondation Eugène Devic EDMUS contre la Sclérose en Plaques (R.M., C.C., S.V.), Bron; and Centre des Neurosciences de Lyon (R.M., C.C., S.V.), INSERM 1028 et CNRS UMR5292, Equipe Neuro-oncologie et Neuro-inflammation, France. sandra.vukusic@chu-lyon.fr.

Abstract

OBJECTIVE:

To evaluate the risk of relapses during pregnancy and in the first 3 months after delivery in 2 successive pregnancies in a cohort of French and Italian women with multiple sclerosis (MS).

METHODS:

A total of 93 women were included if they had had 2 pregnancies followed prospectively after MS onset between January 1993 and 2013. The association of a relapse during pregnancy or the first postpartum trimester in pregnancy 1 and pregnancy 2 was evaluated by univariate logistic regression.

RESULTS:

A majority of women did not experience any exacerbation in the 3 months after delivery (31.2% and 23.7%, respectively, relapsed after pregnancy 1 and 2; p = 0.32). A total of 7.6% had a relapse after both pregnancies. The risk of relapse after pregnancy 2 was not associated with the number of relapses in the prepregnancy year (odds ratio [OR] 1.52 [0.57-4.05]) or during pregnancy (OR 1.57 [0.52-4.79]) or with the occurrence of a relapse after pregnancy 1 (OR 0.86 [0.29-2.50]).

CONCLUSIONS:

Our work provides original data on the evolution of successive pregnancies in MS, showing a similar (and even lower) disease activity in the second pregnancy. There was no correlation of activity in successive pregnancies. Therefore, counseling of women with MS who consider having a second baby should be the same as for the first one.

PMID:
27466470
DOI:
10.1212/WNL.0000000000003036
[Indexed for MEDLINE]

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