Annette Langer-Gould, MD, PhD: No Increased Risk for Postpartum MS Relapses

“Not only are the women with MS much less sick now than they were 20 years ago, and what I mean by that is they’re having far fewer relapses both before, during, and after pregnancy—but there also is no longer an increased risk of relapse in the postpartum period.”

At the 2019 American Academy of Neurology (AAN) Annual Meeting, May 4-10, in Philadelphia, data was presented from a cohort of 375 women with MS, for a total of 466 pregnancies, which ultimately showed that in a contemporary MS population, there is no longer an increased risk of relapse during the postpartum period, as historically suggested by the literature.

Annette Langer-Gould, MD, PhD, regional lead, clinical and translational neuroscience, Kaiser Permanente, and colleagues observed a decline in annualized relapse rates from 0.39 in the pre-pregnancy period to between 0.14 and 0.7 during pregnancy (P <.0001). Altogether, 8.4% relapsed during pregnancy. As well, 38% of the cohort was not on any therapy in the 12 months prior to conception. Of the entire group, 14.6% had clinically isolated syndrome.

In the postpartum period, there was no observed rebound in disease activity, with relapse rates being suppressed in the first 3 months postpartum, to 0.27 (P = .02) and returning to rates similar to pre-pregnancy (0.37) from months 4 to 6 postpartum.

To find out more about the study’s findings and its takeaways for the clinical community, NeurologyLive spoke with Langer-Gould. She shared insight into the impact of exclusive breastfeeding, as well as how the findings impact women with the disease.

For more coverage of AAN 2019, click here.

REFERENCE

Langer-Gould A, Smith J, Albers K, et al. Pregnancy-related Relapses in a Large, Contemporary Multiple Sclerosis Cohort: No Increased Risk in the Postpartum Period. Presented at: American Academy of Neurology Annual Meeting; May 4-9, 2019; Philadelphia, PA. Platform S6.007.