title: Neonatal and delivery outcomes in women with multiple sclerosis.
abstract: OBJECTIVE
  To determine (1) whether the risk of adverse neonatal and delivery outcomes differs between mothers with and without multiple sclerosis (MS) and (2) whether risk is differentially associated with clinical factors of MS.
  
  
  METHODS
  This retrospective cohort study analyzed data from the British Columbia (BC) MS Clinics' database and the BC Perinatal Database Registry. Comparisons were made between births to women with MS (n = 432) and to a frequency-matched sample of women without MS (n = 2,975) from 1998 to 2009. Outcomes included gestational age, birth weight, assisted vaginal delivery, and Caesarean section. Clinical factors examined included age at MS onset, disease duration, and disability. Multivariate regression models adjusting for confounding factors were built for each outcome.
  
  
  RESULTS
  Babies born to MS mothers did not have a significantly different mean gestational age or birth weight compared to babies born to mothers without MS. MS was not significantly associated with assisted vaginal delivery (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.50-1.16; p = 0.20) or Caesarean section (OR, 0.94; 95% CI, 0.69-1.28; p = 0.69). There was a slightly elevated risk of adverse delivery outcomes among MS mothers with greater levels of disability, although findings were not statistically significant. Disease duration and age at MS onset were not significantly associated with adverse outcomes.
  
  
  CONCLUSIONS
  This study provides reassurance to MS patients that maternal MS is generally not associated with adverse neonatal and delivery outcomes. However, the suggestion of an increased risk with greater disability warrants further investigation; these women may require closer monitoring during pregnancy.
authors.affiliation: Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mia L
authors.initials: ML
authors.lastname: van der Kop
authors.forename: Mark S
authors.initials: MS
authors.lastname: Pearce
authors.forename: Leanne
authors.initials: L
authors.lastname: Dahlgren
authors.forename: Anne
authors.initials: A
authors.lastname: Synnes
authors.forename: Dessa
authors.initials: D
authors.lastname: Sadovnick
authors.forename: Ana-Luiza
authors.initials: AL
authors.lastname: Sayao
authors.forename: Helen
authors.initials: H
authors.lastname: Tremlett
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000639:trends*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth / Q000453:epidemiology*; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult