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The influence of pregnancy on the course of multiple sclerosis (MS) has long been a topic of considerable interest to patients and health care practitioners because MS strikes most often in women of childbearing age. Until a few decades ago, women were discouraged from having a baby, fearing that pregnancy would worsen the course of disease. Since then, numerous studies have shown a reduced risk of relapse during pregnancy, followed by an increased risk of disease reactivation after delivery, most clearly revealed in a large prospective study published in 1998.1 Subsequently, the advent of the “treatment era” for MS has introduced complexity into family planning counseling and decision processes, which require additional consideration for numerous disease-modifying drugs (DMDs) before and after pregnancy. To support family planning decisions and to improve available health care services, there remains a great need for a better understanding of the natural history of MS and pregnancy in the context of an ever-expanding number of DMDs.2
Footnotes
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- © 2018 American Academy of Neurology
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