MS and pregnancy

[mtemm]

Has anybody known anyone with MS who was able to a) get pregnant and b) have a healthy pregnancy? I'm a little concerned about dh's aunt. she is 36 and she and her husband have decided they do want to have children (had a change of heart) and are going to start trying soon. She has MS, and while not debilitated, it knocks her out sometimes. Her husband is much younger than her (26) but has type 1 diabetes. Neither of them take care of themselves...both are overweight, both smoke, both neglect what they should be doing nutrition wise. They are both wonderful people who would make great parents, but their health issues scare me. I am not sure if the issues would affect fertility or not. And when I think of her with the aches and pains that she has now, adding pregnancy ones onto it, I just am concerned.

does anyone have any insight. don't get me wrong, it is not my place to say anything or even to voice my concerns, so I won't. But if anyone has any insight I'd appreciate it. And if you have anything that might even show positives from it (I have this vague recollection of reading years ago about pregnancy relieving ms symptoms) that would be very helpful, too. Dh's grandmother (her mom) is really scared about them even thinking about kids.

 

[JennyMominRI]

Has anybody known anyone with MS who was able to a) get pregnant and b) have a healthy pregnancy? I'm a little concerned about dh's aunt. she is 36 and she and her husband have decided they do want to have children (had a change of heart) and are going to start trying soon. She has MS, and while not debilitated, it knocks her out sometimes. Her husband is much younger than her (26) but has type 1 diabetes. Neither of them take care of themselves...both are overweight, both smoke, both neglect what they should be doing nutrition wise. They are both wonderful people who would make great parents, but their health issues scare me. I am not sure if the issues would affect fertility or not. And when I think of her with the aches and pains that she has now, adding pregnancy ones onto it, I just am concerned.

does anyone have any insight. don't get me wrong, it is not my place to say anything or even to voice my concerns, so I won't. But if anyone has any insight I'd appreciate it. And if you have anything that might even show positives from it (I have this vague recollection of reading years ago about pregnancy relieving ms symptoms) that would be very helpful, too. Dh's grandmother (her mom) is really scared about them even thinking about kids.

I have an online friend with MS..
She has had 2 babies since her diagnosis and said she had less symptoms while pregnant.

 

[JennyMominRI]

I found this

Is there any way to prevent exacerbations of multiple sclerosis (MS) during pregnancy and in the postpartum period?



Response from Patricia K. Coyle, MD
Professor of Neurology, and Director, MS Comprehensive Care Center, School of Medicine, State University of New York at Stony Brook.





In general, relapses of MS actually decrease during pregnancy, particularly during the last trimester when they are reduced to 70% below the prepregnancy baseline. This most likely reflects the fact that pregnancy is immunosuppressive. There are no data to show that the unusual relapses that can occur during pregnancy are any different from those that occur prepregnancy, and they can be treated with high-dose steroids once past the first trimester. In the 3 months postpartum, the relapse rate increases to 70% over the prepregnancy baseline, but then returns to the baseline level. Therefore, the several months after giving birth are recognized as a time of high risk for MS disease attacks.
At the current time, an ongoing trial is examining whether intravenous immune globulin (IVIG) given at the time of delivery (at 10 g or 60 g), followed by monthly IVIG (10 g) for 6 months, can prevent relapses. One hundred women with MS are being entered into this trial. If a patient is not going to breastfeed, disease-modifying therapy can be restarted immediately after delivery as well. Theoretically, combination therapy with an A, B, C drug (Avonex, Betaseron, Copaxone) plus IVIG or pulse steroids could be given for 3-6 months postpartum.

 

[JennyMominRI]

More

Effects of Pregnancy on MS: Prior to 1950, most women with MS were counseled to avoid pregnancy because of the belief that it might make their MS worse. Over the past 40 years, many studies have been done in hundreds of women with MS and they have almost uniformly reached the opposite conclusion. Pregnancy appears to have a relatively protective effect on women with MS. The number of MS exacerbations is reduced during pregnancy, especially in the second and third trimesters. An exacerbation—also known as an attack, relapse, or flare—is a sudden worsening of an MS symptom or symptoms, or the appearance of new symptoms, which lasts at least 24 hours and is separated from a previous exacerbation by at least one month.


Effects in the Postpartum Period: Exacerbation rates may rise in the first three to six months postpartum, and the risk of a relapse in the postpartum period is estimated to be 20-40%. These relapses do not appear to contribute to increased long-term disability. In the studies with long-term follow-up of women with MS who had children, no increased disability as a result of pregnancy was found.

Pregnancy is known to be associated with an increase in a number of circulating proteins and other factors that are natural immunosuppressants. Additionally, levels of natural corticosteroids are higher in pregnant than non-pregnant women. These may be some of the reasons why women with MS tend to do well during pregnancy.

 

[saucymb]

A college professor of mine had MS, and when she was in her late 30's (I would guess that was her age), she and her husband finally conceived. Her physical MS symptoms were somewhat severe, and she often struggled before she was pregnant with day to day things. Her pregnancy was uneventful, though I don't remember the details, and she did deliver a very healthy, very cute little baby girl. That was about 8 or 9 years ago. She did stop teaching when she was around 5 or 6 months along per her doctor's orders, but after she had the baby she came back and was a guest speaker at my Recreation for Special Populations class. She talked about her pregnancy, delivery, and post-partum issues. I had heard that pregnancy can temporarily diminish some of the symptoms of MS, and she confirmed that although her energy levels were low (but so were mine and I don't have MS!), overall she felt better. She left and went to teach at another university after the baby was born, and I haven't heard much since. I wish your family the best of luck in this decision making process!

 

[lil mermaid]

I have a good friend who has MS. She was not diagnosed until after her 3 year old son was born, however.

She and her husband are trying to decide if they want to have a second child (they are undecided because of her age and her son's disabilities - it isn't because of the MS.)

Here is what she told me - there isn't any evidence that MS causes fertility problems, and there are actually fewer symptoms during pregnancy. The MS alone doesn't make it unsafe to get pregnant and have babies.

The National MS Society has some good information on MS and pregnancy.

The other stuff is worrisome, though, I agree - especially the smoking and eating issues.

Edited to add - there are often more flare-ups during the post-partum period, and it is often when women are diagnosed (that is what happened with my friend.)

 

[Aimeedyan]

A friend of mine had twins - she has a rather severe case of MS. Her pregnancy was normal and healthy and both babies are precious =)