title: Labor induction and augmentation in women with multiple sclerosis.
abstract: BACKGROUND
  Fatigue and pelvic organ dysfunction are common among women with multiple sclerosis (MS), which may prolong labor and increase the risk of labor induction and/or augmentation.
  
  
  OBJECTIVE
  We set out to investigate the association between MS and related clinical factors (disease duration and the Expanded Disability Status Scale, EDSS) with labor induction/augmentation.
  
  
  METHODS
  Data from the British Columbia (BC) MS database were linked with the BC Perinatal Database Registry. Multivariable models were used to compare the likelihood of labor induction and augmentation between attempted vaginal deliveries (1998-2009) in women with MS (n=381) and the general population (n=2615).
  
  
  RESULTS
  In the MS cohort, 94/381 deliveries (25%) required labor induction and 147/381 deliveries (39%) required labor augmentation. Having MS was not associated with labor induction (adjusted odds ratio (OR)=0.91; 95% confidence interval (CI)=0.68-1.22, p=0.54) or augmentation (adjusted OR=0.91; 95% CI=0.72-1.15, p=0.43), but was associated with multiple methods of labor induction (OR=1.94; 95% CI=1.23-3.06, p=0.004). A higher EDSS score was associated with an increased risk of labor induction (adjusted p=0.04), but not labor augmentation (adjusted p > 0.5). Disease duration was not associated with either outcome (adjusted p > 0.2).
  
  
  CONCLUSIONS
  Greater intervention may be required to initiate labor for women with a higher degree of disability due to MS.
authors: Department of Medicine (Division of Neurology), Faculty of Medicine, University of British Columbia, Canada.
authors: E
authors: E
authors: Lu
authors: F
authors: F
authors: Zhu
authors: Ml
authors: M
authors: van der Kop
authors: L
authors: L
authors: Dahlgren
authors: A
authors: A
authors: Synnes
authors: Ad
authors: A
authors: Sadovnick
authors: A
authors: A
authors: Traboulsee
authors: H
authors: H
authors: Tremlett
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data*; D009103:Multiple Sclerosis / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D055815:Young Adult
keywords: Multiple sclerosis; birth; childbirth; cohort studies; labor; pregnancy