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Investigation of pregnancy tendency, reproductive characteristics, and disability in women with multiple sclerosis: A secondary data analysis of the national registry in Iran

Articles in Press

Document Type : Original Article

Authors

1 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Neurology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

4 Musculoskeletal Rehabilitation Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran

5 Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran

6 Department of Neurology, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran

7 Department of Neurology, School of Medicine, Arak University of Medical Sciences, Arak, Iran Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran

8 Department of Neurology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

9 Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

10 Department of Neurology, School of Medicine, Qom University of Medical Sciences, Qom, Iran

11 Department of Neurology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

12 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: Multiple sclerosis (MS) predominantly affects women of childbearing age, significantly impacting their quality of life (QOL). 
The diagnosis of MS can influence pregnancy intention, and the level of disability associated with MS may change before and after pregnancy. This study aims to analyze the reproductive characteristics of Iranian female patients with MS (PwMS) and their association with the Expanded Disability Status Scale (EDSS) and pregnancy tendency, providing valuable insights into disease progression and the development of tailored treatments.
Methods: A cross-sectional study was conducted using data from the nationwide MS registry of Iran (NMSRI) from 2018 to 2021. Patients without a documented history of pregnancy, MS type, or EDSS score were excluded from the study. Various statistical methods, including nonparametric tests, the generalized estimating equation (GEE) model, and multiple logistic regression, were employed to analyze the data.
Results: The study included 1120 PwMS with a median diagnostic age of 31 and a disease duration of 6 years. The majority had relapsing-remitting MS (RRMS) and the mean EDSS score at bassline was 1.5 ± 1.4. A history of pregnancy or abortion was associated with higher EDSS scores. Multiparity before MS diagnosis was linked to EDSS score ≥ 5, while this EDSS range was associated with decreased parity after MS diagnosis (all P-values < 0.05).
Conclusion: Pregnancy and parity can affect the disability in female PwMS irrespective of clinical symptoms, diagnosis age, and MS type. Moreover, the chance of parity may be affected by a higher disability score, which should be considered in the clinical setting.

Keywords

References
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Current Journal of Neurology

Articles in Press, Accepted Manuscript
Available Online from 18 June 2024
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