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MS Relapse Drops During Pregnancy but Rises After

Disease-modifying drug use uncommon year before pregnancy and further drops during pregnancy

MONDAY, Nov. 19, 2018 (HealthDay News) — Rates of multiple sclerosis (MS) relapse decrease during pregnancy but increase postpartum, according to a study published online Oct. 23 in Neurology.

Maria K. Houtchens, M.D., from Brigham and Women’s Hospital in Boston, and colleagues retrospectively analyzed U.S. commercial health plan claims data from 2,158 women with MS and a live birth from Jan. 1, 2006, to June 30, 2015. MS relapse was defined as an MS-related hospitalization, emergency room visit, or outpatient visit with corticosteroid prescription within seven days.

The researchers found that the odds of relapse declined during pregnancy (odds ratio [OR], 0.623), increased during puerperium (OR, 1.710), and ended at a higher level during the last three postpartum quarters (OR, 1.216). Overall, the proportion of women receiving disease-modifying drug (DMD) treatment was rather low: 20 percent prepregnancy, dropping to 1.9 percent during the second trimester, and peaking at 25.5 percent nine to 12 months postpartum. The decline in DMD treatment during pregnancy was significant (OR, 0.171), as it was during puerperium (OR, 0.361) and during the last three postpartum quarters (OR, 1.259).

“The size and relative ease of analysis with this retrospective administrative database, despite its limitations, affords us a great tool for understanding ‘real-world’ outcomes and opportunities for improving patient care,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including EMD Serono, which funded the study.

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