4.5 Review

Maternal Multiple Sclerosis and Health Outcomes the Children: A Review

Journal

CLINICAL EPIDEMIOLOGY
Volume 15, Issue -, Pages 375-389

Publisher

DOVE MEDICAL PRESS LTD
DOI: 10.2147/CLEP.S392273

Keywords

multiple sclerosis; pregnancy; neonatal outcomes; long-term health outcomes; reproduction

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This systematic review examined the literature on in utero exposure to maternal multiple sclerosis (MS) and its influence on offspring health outcomes. The findings suggest that women with MS have an increased risk of preterm birth and small for gestational age. However, no clear conclusions could be drawn for women with MS treated with disease-modifying therapy (DMT) during pregnancy. Additionally, the limited studies on long-term child outcomes showed inconsistent results, particularly in neurodevelopment and psychiatric impairment.
Objective: To summarize the available literature and provide an overview of in utero exposure to maternal multiple sclerosis (MS) and the influence on offspring health outcomes.Methods: We conducted a systematic review by searching Embase, Medline and PubMed.gov databases, and we used covidence.org to conduct a thorough sorting of the articles into three groups; 1) women with MS and the influence on birth outcomes; 2) women with MS treated with disease-modifying therapy (DMT) during pregnancy and the influence on birth outcomes; and 3) women with MS and the influence on long-term health outcomes in the children.Results: In total, 22 cohort studies were identified. Ten studies reported on MS without DMT and compared with a control group without MS, and nine studies on women with MS and DMT prior to or during pregnancy met the criteria. We found only four studies reporting on long-term child health outcomes. One study had results belonging to more than one group.Conclusion: The studies pointed towards an increased risk of preterm birth and small for gestational age among women with MS. In terms of women with MS treated with DMT prior to or during pregnancy, no clear conclusions could be reached. The few studies on long-term child outcomes all had different outcomes within the areas of neurodevelopment and psychiatric impairment. In this systematic review, we have highlighted the research gaps on the impact of maternal MS on offspring health.

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