Pregnancy and childbirth in women with multiple sclerosis

1 Oddział Neurologii I Wojskowego Szpitala Klinicznego w Lublinie. Kierownik: dr Piotr Ostański
2 Katedra i Klinika Neurologii Uniwersytetu Medycznego w Lublinie. Kierownik: prof. dr hab. n. med. Konrad Rejdak
Adres do korespondencji: Lek. med. Małgorzata Czernichowska-Kotiuszko, Oddział Neurologii I Wojskowego Szpitala Klinicznego,
Al. Racławickie 23, 20-904 Lublin, tel.: 81 718 32 32, 608 657 747, faks: 81 718 32 77, e-mail: gczernichowska@wp.pl

AKTUALN NEUROL 2014, 14 (1), p. 25–29
DOI: 10.15557/AN.2014.0002
ABSTRACT

Multiple sclerosis (MS) is the main cause of disability in young adults and, as most autoimmune diseases, more commonly affects women. The relationship between pregnancy and MS has been an issue of significance for many years and has recently become the subject of multicentre studies. Usually, pregnancy is a period of relative wellness for patients and most commonly is a period without relapse. This boost of health involves the change of immune reactivity to anti-inflammation associated with Th2 lymphocytes and anti-inflammatory cytokines (interleukin 4, 5, 6, 10, TGF-β). After giving birth, a woman’s immune system returns to its original level of activity and disease susceptibility increases. Most studies have shown no overall negative impact of pregnancy on longterm disability associated with MS, and MS does not have negative impacts on pregnancy, childbirth or the child’s condition. Women with MS can plan to have children. The disease does not increase the risk of pregnancy/ childbirth complications or birth defects compared to the general population. Each immunomodulatory therapy is contraindicated in pregnancy. If a patient wishes to become pregnant, discontinuation of the therapy much before planned pregnancy is recommended. The work summarizes available information on clinical problems associated with pregnancy and childbirth in patients with MS and analyses risks to the child associated with the administration of drugs.

Keywords: multiple sclerosis, pregnancy, childbirth, cytokines anti-inflammatory, magnetic resonance imaging