Does MS affect your baby?

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There is little information out there on the effect of MS on a baby born to a mother with MS. Previous reports have noted a greater occurrence of pre-term delivery in mothers taking disease-modifying drugs (DMDs), as well as more C-sections and instrumental delivery. Anaemia and a greater occurrence of UTI has also been reported.

In a review of 211 MS pregnancies in Italy comprising of foetal growth scans and early development of the baby, a group in Italy found very few congenital malformations. C-sections were more frequent (in 10% having MS was the indication), as was instrumental delivery (although the latter was not statistically significant compared to the non-MS mothers).

Pre-term delivery was also more common in MS with babies being born at less than 37 weeks gestation, the APGAR score, however, was the same between the two groups. There was no difference compared to non-MS mothers when it came to babies being born <34 weeks gestation. The percentage of smokers was greater in the MS group (6.3%) in this study than the non-MS group (0.8%) and smoking per se has been linked to pre-term delivery.

Overall, babies were not small for age in either group (MS vs. non-MS mothers).

In terms of after delivery growth characteristics the investigators found no difference in head circumference, body weight or length of the baby from their birthdate to 6 to12 months of their life.

Therefore, having a baby when you have MS doesn’t seem to have an impact on foetal growth or postnatal development in year after being born which is good news. The generalisability of this data however is questionable. A larger more prospective data collection across the world would be more helpful in formulating more generalisable outcomes from MS pregnancies.

Abstract

Mult Scler Relat Disord 2022 Aug 1;65:104087.

Fetal and post-natal growth in infants of mothers with multiple sclerosis: A case-control study

Luca Marozio Paola Cavalla Stefano Sottemano Marco Vercellino Francesca Federici Stefano Cosma Chiara Peila Francesco Cresi Alessandra Coscia Marco Capobianco Chiara Bosa Valentina Schillaci Valeria Bellisario Giuseppe Migliaretti Chiara Benedetto 

Background: Multiple sclerosis does not seem to adversely affect fetal and neonatal outcomes, although some studies reported a possible reduction in mean birth weight and length, and a higher incidence of preterm delivery, mainly in relation to the exposure to disease-modifying drugs (DMDs) during pregnancy. Few data are available on intrauterine fetal growth and postnatal somatic development of newborns from mothers with multiple sclerosis compared to those from healthy women. For these reasons, we decided to investigate fetal growth, neonatal anthropometric parameters, and postnatal somatic development up to 12 months of life in offsprings from MS mothers.

Methods: This retrospective cohort study included 211 women with multiple sclerosis, and 384 healthy women paired for maternal age and parity as controls. Fetal biometric parameters (biparietal diameter, head circumference, abdominal circumference, and femur length) measured during the third trimester of pregnancy (30-34 weeks’ gestation) were retrieved from the computerized database of the Department (EcoPlus*) where the results of ultrasound exams performed in the hospital are stored. Newborn measurements (weight, length and head circumference) at birth were obtained from the hospital’s computerized obstetric and neonatal database (Trackare* and Remote* data base); measurements at 6 and 12 months of life were obtained from the regional database (ECWMED*) of family pediatricians of our region.

Results: No differences between the two groups were observed for all the fetal parameters considered, expressed as centiles of growth according to gestational age (biparietal diameter: p = 0.40; head circumference: p = 0.40; abdominal circumference: p = 0.32; femur length: p = 0.32). No differences in gestational age at delivery, birthweight, and in the incidence of low birthweight and small for gestational age newborns were observed between the two groups. In the multiple sclerosis group a significantly higher incidence of caesarean section (p = 0.01) and late preterm delivery (at less than 37 weeks’gestation, p = 0.001) were registered. The trends of postnatal growth in weight (F = 0.53; p-value = 0.590) and length (F = 0.44; p-value = 0.645) were superimposable between the two groups. The trends of growth for head circumference showed a slightly, not significantly greater head circumference of infants from mothers with multiple sclerosis at 6 months of life, but the values at twelve months of life in the two groups were similar (F = 0.85; p-value = 0.427) . Moreover, the trends of postnatal increase of weight (F = 1.016; p-value = 0.331), length (F = 2.001; p-value = 0.146) and head circumference (F = 1.591; p-value = 0.212) of newborns/infants (from birth to twelve months of life) born to mothers with multiple sclerosis who breastfed, mothers who did not, and in the control group were similar.

Conclusion: Multiple sclerosis in pregnancy does not seem to affect fetal growth and postnatal development during the first year of the offspring life. We think that these results represent an important and reassuring information to provide the patients with during preconception counseling.

About the author

Neuro Doc Gnanapavan

2 comments

  • My presumed onset was 7 months after I delivered. I’ve always wondered if something about pregnancy triggered it, or if it was already there beforehand and I just didn’t know. I am glad that this study shows it is generally safe for people to have children with MS. I am sure it will help to reassure many people.

  • Isn’t the real issue about the prognosis for the mother (and father)? Many MSers are into the SPMS stage after c.15-20 years. Many will require a wheelchair or care support. Prof G used to mention the high rates of relationship breakdown, job loss, depression…. Having a five year old, ten year old, fifteen year old child can bring many challenges. These issues need to be thought through carefully, especially for older mothers. This vile disease affects so much including one of the greatest roles – being a mother or father.

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