The majority of women who have MS are diagnosed in their twenties and thirties, at a time when they may be thinking about starting a family.
There have been many studies examining the impact of pregnancy on MS. They all show that pregnancy appears to have a positive protective influence, with relapse rates going down, especially during the third trimester (between six and nine months). The reasons for this are not fully understood, but it is thought that hormone levels play a role. However, in the first three months after the baby is born, the risk of relapse rises. This is thought to occur as hormones return to pre-pregnancy levels.
It remains unknown whether there is any association between the numbers of relapses experienced if a woman has more than one pregnancy. If such a relationship does exist, neurologists could provide informed advice to women with MS after their first pregnancy.
This study looked at a group of 93 French and Italian women with MS who had had two consecutive pregnancies. Researchers evaluated the risk of relapses during pregnancy and in the first three months after delivery in both pregnancies.
The results showed that there was no difference in the disease activity between two pregnancies. There was also no difference between the rebound attacks after the pregnancy, when researchers compared the first and second pregnancies.
Therefore, the researchers suggest that, counseling of women with MS who consider having a second baby should be the same as for the first one. During counselling, doctors should advise on both protective effects of pregnancy against relapses, and the increased chance of new relapses in the first three months after the baby is born.
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