Introduction:
Multiple sclerosis (MS) is an autoimmune disorder affecting the brain and spinal cord. This condition may affect one in thousands. It was found that MS occurs most commonly among women, and the recent ratio of affected women is 3:1. According to the estimated results of the studies, it was found that MS occurs among women below 50 years of age. It was also noticed that one in three women gets pregnant after the diagnosis of MS. It is a challenging aspect to treat MS preconception, pregnancy, and postpartum without causing risks to the mother and child.
What Is Multiple Sclerosis?
MS is a chronic condition that affects the central nervous system (the brain and spinal cord). This condition is caused by genetic factors, environmental factors, autoimmune disorders, and viruses. All these causes cause the immune system to destroy the nerve cell sheath. Because of this, signals get affected, and communication is interrupted.
Symptoms of MS include:
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Muscles get weakened and show stiffness and cramps.
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Exhibit pain, tingling, and numbness in the body.
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Tremors in hands and legs can be observed.
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Loss of balance can be seen.
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Problems in walking, speaking, and vision can be observed.
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Tiredness and dizziness are observed.
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Bladder or bowel problems can be seen.
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Problems with thinking and memory can be observed.
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Depression can be observed.
It was found that women are affected more than men by MS, and it mostly affects women in their childbearing years. This makes them do family planning.
How Are Multiple Sclerosis and Pregnancy Related?
Previously, it was thought that women with MS should not go for childbearing, but recent studies have disapproved of this thought. It was found that MS does not cause difficulty in getting pregnant, and it does not increase the risk of complications of pregnancy. It was also found that a child in the future has the risk of getting affected by MS if one of the parents has certain types of MS.
Family planning can be done to know more about the proper time to get pregnant, whether to have one child or two, and whether to breastfeed. All this information should be discussed with the neurologist and gynecologist.
In pregnancy, it was observed that there is a change in the way the immune system behaves. This change helps to act so that the body does not attack the developing baby as an intruder. These changes can even alter the symptoms of MS.
As a result, many individuals with MS have shown a reduction in the symptoms during pregnancy. This even reduced the relapse of MS in the postpartum period. These changes may not be the same for every individual because they may vary from one person to another.
What Problems Are Faced by an Individual With MS in Pregnancy?
Individuals with MS may not have problems getting pregnant. Many of these women may have symptoms of MS as it was present before or may get better, especially in the third trimester of the pregnancy.
Problems that women could face with MS include:
A Small for Gestational Age Baby: A baby is born as small compared to normal based on the number of weeks the baby is in the womb.
Trouble in Pushing Baby: Symptoms of MS may affect pelvic muscles and nerves, which may lead to troubles in pushing out the baby during delivery.
A Cesarean Birth: Women affected by MS are more likely to undergo a cesarean surgery when compared to normal women. The reason for this is that the symptoms of MS are responsible for muscle problems, which delay labor.
It was found that women with MS may exhibit flare-ups in the first three months after the delivery of the baby. Researchers have thought that pregnancy does not affect the overall course of MS later in life.
What Are the Effects of Multiple Sclerosis on Pregnancy?
It was found that MS does not affect pregnancy, and it was found to be safe even to breastfeed the baby.
MS may influence getting pregnant. This may be due to the difficulty of sexual intercourse among women with MS, which makes it painful. This is the reason why artificial insemination is found to be more common among those with MS.
Some of the drugs used for MS treatment may cause problems in pregnancy. Disease-modifying therapy (DMT) drugs used in MS have shown the risk to the developing fetus. Hence, these drugs are not recommended by doctors. A study conducted among pregnant women exposed to DMT drugs during the first trimester of pregnancy exhibited comparable outcomes when compared to those without exposure.
What Are the Effects of Pregnancy on Multiple Sclerosis?
Hormonal changes during pregnancy may affect MS. Sex hormones like progesterone and estrogen tends to influence the symptoms of MS. Studies have been found to improve the condition called MS during pregnancy.
Changes that occur during pregnancy, like changes in the immune system, may reduce the different types of inflammatory chemicals in the body. Meanwhile, these changes promote anti-inflammatory chemicals that may be responsible for reducing the symptoms of MS.
A study conducted in 2018 found that a pregnancy hormone called human chorionic gonadotrophin may be responsible for changing the behavior of specific white blood cells. This change causes a reduction in the activation of the immune system. This, in turn, helps reduce inflammation and ease the symptoms of MS.
Pregnancy is thought to reduce the activation of the immune system, but this may not be true for everyone. Stopping a few drugs like DMT during pregnancy may lead to a worsening of symptoms and may increase the risk of relapses.
Complications:
MS does not increase risks such as stillbirth, congenital disabilities, and miscarriage. According to a study conducted in 2021, it was found that complications do not differ for those with MS when compared to those without MS. The condition did not increase the risk for emergency cesarean surgery, gestational diabetes, preeclampsia, or placenta issues.
Conclusion:
MS is a chronic condition in which there is a loss of the myelin sheath of nerve cells, leading to trouble in the transportation of signals from the brain to other parts of the body. This condition does not affect pregnancy, and women with MS may have healthy babies as normal women. Many factors must be discussed with concerned healthcare providers before pregnancy. Hence, it becomes important to know about MS, its symptoms, problems related to pregnancy among those with MS, and the effects of MS and pregnancy on each other.
