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January 29, 2013; 80 (5) Article

Birth hospitalization in mothers with multiple sclerosis and their newborns

Ellen Lu, Yinshan Zhao, Feng Zhu, Mia L. van der Kop, Anne Synnes, Leanne Dahlgren, A. Dessa Sadovnick, Ana-Luiza Sayao, Helen Tremlett, On behalf of the British Columbia Multiple Sclerosis Clinic Neurologists
First published January 9, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31827f0efc
Ellen Lu
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Yinshan Zhao
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Feng Zhu
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Mia L. van der Kop
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Anne Synnes
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Leanne Dahlgren
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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A. Dessa Sadovnick
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Ana-Luiza Sayao
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Helen Tremlett
From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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From the Department of Medicine, Division of Neurology (E.L., Y.Z., F.Z., M.L.v.d.K., A.D.S., A.-L.S., H.T.), Departments of Pediatrics (A.S.), Obstetrics and Gynaecology (L.D.), and Medical Genetics (A.D.S.), Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Birth hospitalization in mothers with multiple sclerosis and their newborns
Ellen Lu, Yinshan Zhao, Feng Zhu, Mia L. van der Kop, Anne Synnes, Leanne Dahlgren, A. Dessa Sadovnick, Ana-Luiza Sayao, Helen Tremlett, On behalf of the British Columbia Multiple Sclerosis Clinic Neurologists
Neurology Jan 2013, 80 (5) 447-452; DOI: 10.1212/WNL.0b013e31827f0efc

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Abstract

Objective: To compare the duration of birth hospitalization in mothers with multiple sclerosis (MS) and their newborns relative to the general population and to investigate the impact of MS-related clinical factors on the length of birth hospitalization stays.

Methods: Data from the British Columbia Perinatal Database Registry and the British Columbia MS database were linked in this retrospective cohort study. The duration of birth hospitalization in mothers with MS and their newborns (n = 432) were compared with a frequency-matched sample of the general population (n = 2,975) from 1998 to 2009. Clinical factors investigated included disease duration and disability, as measured by the Expanded Disability Status Scale. A multivariable model (generalized estimating equations) was used to analyze the association between MS and duration of birth hospitalization, adjusting for factors such as maternal age, diabetes, hypertension, and consecutive births to the same mother. Additional analyses included propensity score matching to further balance cohort characteristics.

Results: Compared with the general population, the duration of birth hospitalization was not statistically or clinically different for mothers with MS or their newborns (median differences = +1.5 and +2.1 hours, respectively; adjusted p > 0.4). Lengths of birth hospitalization were not significantly associated with disease duration (adjusted p > 0.7) or level of disability (adjusted p > 0.5). Findings remained virtually unchanged after propensity score matching.

Conclusions: Birth hospitalization has been understudied in women with MS. Contrary to existing studies, we found that MS was not associated with a longer birth hospitalization. This study provides assurance to expectant mothers with MS, their families, and health care providers.

GLOSSARY

BC=
British Columbia;
BCMS=
British Columbia Multiple Sclerosis;
BCPDR=
British Columbia Perinatal Database Registry;
BMI=
body mass index;
CI=
confidence interval;
EDSS=
Expanded Disability Status Scale;
ICD=
International Classification of Diseases;
MS=
multiple sclerosis;
NICU=
neonatal intensive care unit;
PS=
propensity score

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received May 8, 2012.
  • Accepted September 14, 2012.
  • © 2013 American Academy of Neurology
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