Parity is associated with a longer time to reach irreversible disability milestones in women with multiple sclerosis

Background: Multiple sclerosis (MS) frequently affects women of childbearing age. While short-term effects of pregnancy on MS course are well-known, whether pregnancy may influence long-term disability progression is debated. Methods: A two-centre retrospective study to investigate long-term effect...

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Vydáno v:Multiple sclerosis Ročník 21; číslo 10; s. 1291 - 1297
Hlavní autoři: Masera, S, Cavalla, P, Prosperini, L, Mattioda, A, Mancinelli, CR, Superti, G, Chiavazza, C, Vercellino, M, Pinessi, L, Pozzilli, C
Médium: Journal Article
Jazyk:angličtina
Vydáno: London, England SAGE Publications 01.09.2015
Sage Publications Ltd
Témata:
Adult
Age of Onset
Disability Evaluation
Disabled Persons
Disease Progression
Female
Humans
Multiple Sclerosis - diagnosis
Multiple Sclerosis - epidemiology
Multiple Sclerosis - mortality
Parity - physiology
Pregnancy
Retrospective Studies
Risk
Survival Analysis
Multiple sclerosis
disease progression
childbearing
parenthood
disability
pregnancy
ISSN:1352-4585, 1477-0970, 1477-0970
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Shrnutí:Background: Multiple sclerosis (MS) frequently affects women of childbearing age. While short-term effects of pregnancy on MS course are well-known, whether pregnancy may influence long-term disability progression is debated. Methods: A two-centre retrospective study to investigate long-term effect of pregnancy on disability was performed in a population of MS women. Survival analyses and multivariate Cox proportional regression models (including early predictors of MS severity and exposure to disease-modifying treatments) were performed to compare time to reach well-established disability milestones in nulliparous women and in those with pregnancies after MS onset (‘parous’). Women with pregnancies before MS onset were excluded from analyses as they represent a heterogeneous group. Results: Data about 445 women (261 nulliparous, 184 ‘parous’) were analysed. A longer time to reach Expanded Disability Status Scale (EDSS) 4.0 and 6.0 was observed in parous women; Cox regression models revealed a lower risk for ‘parous’ than nulliparous women in reaching EDSS 4.0 and 6.0 (HR = 0.552, p = 0.008 and HR = 0.422, p = 0.012 respectively). Conclusion: Our findings suggest that pregnancy after MS onset is associated with a slower long-term disability progression. Whether this represents a biological/immunological effect, or reflects a higher propensity toward childbearing in women with milder disease, it remains uncertain deserving further investigations.
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ISSN:1352-4585
1477-0970
1477-0970
DOI:10.1177/1352458514561907