Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Women with MS: Increased Risks During Pregnancy

Am J Epidemiol; ePub 2018 Aug 28; MacDonald, et al

Overall, pregnant women with multiple sclerosis (MS) had an increased risk of infections and preterm delivery, according to a recent study. However, their risks for other adverse pregnancy outcomes were not elevated. Furthermore, disease activity before delivery was not a strong predictor of outcomes. Researchers used 2 large US administrative databases (2011-2015 Truven Health Marketscan Database; 2007-2011 Nationwide Inpatient Sample) to identify delivery cohorts. MS and pregnancy outcomes (infections, cesarean section, preterm delivery, poor fetal growth, preeclampsia, chorioamnionitis, postpartum hemorrhage, stillbirth, infant malformations) were identified during pregnancy and at delivery. They calculated adjusted risk ratios by MS status and relapses in the year before delivery. Among >5 million pregnancies, 3,875 were identified in women with MS. They found:

  • Women with MS had an increased risk of infections during pregnancy (adjusted risk ratio Truven: 1.22) and preterm delivery (Truven 1.19); Nationwide Inpatient Sample 1.30.
  • The risk of other outcomes was similar for women with and without MS.
  • In Truven, risk ratios of the pregnancy outcomes in women experiencing relapses vs those without relapses were between 0.9 and 1.4, and confidence intervals overlapped the null.

Citation:

MacDonald SC, McElrath TF, Hernández-Díaz S. Pregnancy outcomes in women with multiple sclerosis. [Published online ahead of print August 28, 2018]. Am J Epidemiol. doi:10.1093/aje/kwy197.

This Week's Must Reads

Unilateral Thalamic Stimulation Improved Axial ET, Parkinsonism Relat Disord; ePub 2018 Sep 6; Mitchell, et al

Balance-Gait Disorder Risk Factor for Dementia in PD, J Parkinsons Dis; ePub 2018 Aug 13; Lichter, et al

Suicidal Ideation Prevalent in Persons with HD, J Huntingtons Dis; 2018 Jul 31; Wesson, et al

Everyday Functioning in Parkinson Disease Assessed, Parkinsonism Relat Disord; ePub 2018 Sep 1; Lopez, et al

Comparison of 2 DBS Methods for Essential Tremor, Mov Disord; ePub 2018 Sep 5; Fenoy, Schiess

Must Reads in Multiple Sclerosis

Cognitive Reserve Lessens Disability’s Effect on MS, Clin Neuropsychol; ePub 2018 Aug 28; Cadden, et al

Assessing Sexual Dysfunction in Patients with MS, Int J MS Care; 2018 Jul-Aug; Domingo, et al

Multiple Sclerosis Affects Memory Task Performance , Int J MS Care; 2018 Jul-Aug; Barbu, Berard, et al

Women with MS: Increased Risks During Pregnancy, Am J Epidemiol; ePub 2018 Aug 28; MacDonald, et al

Gait Variability, Energy Cost in Persons with MS, Am J Phys Med Rehab; 2018 Sep; Sebastião, et al