Acta Neurol Scand. 2004 Jul;110(1):23-6
Salemi G, Callari G, Gammino M, Battaglieri F, Cammarata E, Cuccia
G, D'Amelio M, Lupo I, Ragonese P, Savettieri G.
Institute of Neuropsychiatry, University of Palermo, Palermo, Italy.
Objective -
To evaluate the influence of pregnancy and puerperium on the relapse rate of multiple sclerosis (MS).
Methods -
We determined retrospectively the yearly mean relapse rate (MRR) during pregnancies occurring in the course of relapsing-remitting MS.
We compared the MRR of pregnancy-time with that of non-pregnancy time by paired t-test.
Relative risk (RR) of relapses during the pregnancy-time was also compared with that of non-pregnancy time by chi(2) analysis and 95% confidence intervals.
Results -
From a population of 351 women affected by clinically definite MS, only 70 reported pregnancies during their relapsing-remitting phase of MS for a total of 98 pregnancies.
Both MRR (P = 0.006) and RR (RR = 0.63, 95% CI = 0.40-0.94) decreased during the three trimesters of pregnancy.
RR increased in the first 3 months of puerperium, although this was not statistically significant (RR = 1.36, 95% CI = 0.79-2.20).
Conclusion -
Our study confirms that in MS the relapse rate decreases throughout pregnancy and increases during puerperium.
This suggests a complex interplay between hormonal and immune factors.