Maria Houtchens, MD, of Brigham & Women's Hospital, on relapse rates before, during, and after pregnancy
by MedPage Today Staff
August 15, 2017
We care for a lot of young patients in multiple sclerosis, which is unique. Neurology generally is thought of as a specialty of older people, but MS, and a few other subspecialties, really cater to younger populations. In MS in particular, it's an autoimmune disease, so there are a lot more women than men affected.
Ultimately, we have young women with a chronic, neurologic autoimmune disease, and a lot of our women want to become moms. That's part of their life goal, so it's very important to be able to counsel them and to give them real information based on data -- what their risks are, what the benefits might be, and how their disease is going to behave before, during, and after pregnancy.
There's not much information, unfortunately, especially not in the United States. The first and probably the best-performed study in the subject was done in Europe and was published in 1998 in the New England Journal of Medicine. It was a French group that conducted the study. The author was Confavreux and it was called the PRIMS study. So that project looked at relapse rates before, during, and after pregnancy and really was the first study with few patients, relatively few patients, about 227 I believe, that presented to the world the outcomes of pregnancy and multiple sclerosis and the outcomes of multiple sclerosis as it related to pregnancy.
In the United States ... when we did a literature research, we were surprised just to how little is known and published about this. So this is one of the reasons that we've undertaken this project.