Clinical Evaluation of Multiple Sclerosis Patients during Pregnancy Period in a Sample of Egyptian Patients

Abstract Background Multiple sclerosis is a complex, autoimmune mediated disease of the central nervous system, characterized by inflammatory demyelination and axonal / neuronal damage. There is increasing incidence and prevalence of MS in both developed and developing countries, the underlying cause of which remains uncertain. MS is a complex disease; many genes modestly increase disease susceptibility in addition to several well defined environmental factors, in particular vit D or ultraviolet B light (UVB) exposure, Epstein-Barr virus (EBV) infection, obesity and smoking. Multiple sclerosis (MS) is three times more likely to be seen in women and usually diagnosed between the ages of 20-50 years. Aim of the Work To Study effect of MS and DMDs on pregnancy outcome (natal & postnatal period) and during breast feeding and to study effect of pregnancy on MS regarding relapse rate and disability progression. Patients and Methods This study is an Observational analytical retrospective study, conducted at multiple sclerosis clinic of neurology department at Ain Shams University Hospitals. Patients will be collected retrospectively from June 2018 till June 2022. We will collect 60 female patients diagnosed with multiple sclerosis according to McDonald criteria within the childbearing period. Results We observed that multiple sclerosis has no adverse effect on fertility or gravidity. Also, we observed that there is increase in relapse rate within the postpartum period which is associated with increase in EDSS score compared to that before pregnancy. The early use of DMD before conception has protective effect and delay progression on the other hand, the use of DMD was associated with increased maternal and fetal complications especially low birth weight and preterm delivery. Conclusion Pregnancy is associated with increased relapse rate especially during postpartum period but the early use of DMD before conception is protective against occurrence of relapses and delay onset of progression with no fatal adverse events on the mother or the fetus.