Healthy Pregnancy with MS
What is it?
Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system, mainly
the brain and the spinal cord. Like most autoimmune conditions, research remains inconclusive
on what causes it, other than: antibodies attack healthy tissue. In MS, your body attacks the
myelin sheath: the wiring protecting your nerve cells. This damage causes messages from your
brain to the rest of your body to slow down, or completely stop. Most common treatment for MS
is a Disease Modifying Therapy (DMT), tailored to the patient’s needs and the severity of the
condition.
DMTs and Pregnancy
Women who have been diagnosed with MS and are thinking of becoming pregnant have likely
been told that most DMTs are not safe to use during pregnancy. One of the most common
concerns with stopping DMTs is the risk of relapse after pregnancy. In fact, medical
professionals suggest you stop the therapy altogether once you embark on your pregnancy
journey.
Another research, however, has found that 12% of its women participants were taking a
DMT during the first trimester. This lowered to 3% of participants by the third trimester. This is
not to say that use of DMTs during pregnancy is safe, but it does point to the need for further
research.
What should I expect?
It’s common that during pregnancy most autoimmune diseases—including MS—quiet down:
you may not experience as many symptoms, or your symptoms may lessen. Researchers believe
this is due to the hormones your body produces during pregnancy.
There is no evidence MS causes any miscarriages, stillbirths, or congenital malfunctions. Some
research suggests that premature labor and the risk of infections have been found to be slightly
higher in women with MS. Your doctor may suggest closer monitoring of your pregnancy, more
prenatal visits, and further tests to ensure your health. It’s possible you may need to consider a
C-section, especially if your MS symptoms affect your pelvic muscles and nerves.
What about relapse?
Research has found that the risk of relapse is relatively low during pregnancy. However, it can be
treated with corticosteroids which are generally known to be safe during the first and second
trimester.
After giving birth, studies have found an increased chance of relapse in the first three months. A
significant factor is the stability of the disease prior to pregnancy, and it is used to reduce this
risk. Similar to use of corticosteroids, if you are thinking of breastfeeding, remember that DMTs
can also pass through breastmilk—their use is not recommended if you will be breastfeeding.