Highlights
- •Multiple sclerosis does not seem to adversely affect fetal and neonatal outcomes.
- •We studied fetoneonatal growth in offsprings of mothers with multiple sclerosis.
- •Multiple sclerosis in pregnancy does not seem to affect fetal and neonatal growth.
- •We think that these results represent a very important and reassuring information.
Abstract
Background
Multiple sclerosis does not seem to adversely affect fetal and neonatal outcomes,
although some studies reported a possible reduction in mean birth weight and length,
and a higher incidence of preterm delivery, mainly in relation to the exposure to
disease-modifying drugs (DMDs) during pregnancy. Few data are available on intrauterine
fetal growth and postnatal somatic development of newborns from mothers with multiple
sclerosis compared to those from healthy women. For these reasons, we decided to investigate
fetal growth, neonatal anthropometric parameters, and postnatal somatic development
up to 12 months of life in offsprings from MS mothers.
Methods
This retrospective cohort study included 211 women with multiple sclerosis, and 384
healthy women paired for maternal age and parity as controls. Fetal biometric parameters
(biparietal diameter, head circumference, abdominal circumference, and femur length)
measured during the third trimester of pregnancy (30–34 weeks’ gestation) were retrieved
from the computerized database of the Department (EcoPlus*) where the results of ultrasound
exams performed in the hospital are stored. Newborn measurements (weight, length and
head circumference) at birth were obtained from the hospital's computerized obstetric
and neonatal database (Trackare* and Remote* data base); measurements at 6 and 12
months of life were obtained from the regional database (ECWMED*) of family pediatricians
of our region.
Results
No differences between the two groups were observed for all the fetal parameters considered,
expressed as centiles of growth according to gestational age (biparietal diameter:
p = 0.40; head circumference: p = 0.40; abdominal circumference: p = 0.32; femur length: p = 0.32). No differences in gestational age at delivery, birthweight, and in the incidence
of low birthweight and small for gestational age newborns were observed between the
two groups. In the multiple sclerosis group a significantly higher incidence of caesarean
section (p = 0.01) and late preterm delivery (at less than 37 weeks'gestation, p = 0.001) were registered. The trends of postnatal growth in weight (F = 0.53; p-value = 0.590) and length (F = 0.44; p-value = 0.645) were superimposable between the two groups. The trends of growth for
head circumference showed a slightly, not significantly greater head circumference
of infants from mothers with multiple sclerosis at 6 months of life, but the values
at twelve months of life in the two groups were similar (F = 0.85; p-value = 0.427) . Moreover, the trends of postnatal increase of weight (F = 1.016; p-value = 0.331), length (F = 2.001; p-value = 0.146) and head circumference (F = 1.591; p-value = 0.212) of newborns/infants (from birth to twelve months of life) born to
mothers with multiple sclerosis who breastfed, mothers who did not, and in the control
group were similar.
Conclusion
Multiple sclerosis in pregnancy does not seem to affect fetal growth and postnatal
development during the first year of the offspring life. We think that these results
represent an important and reassuring information to provide the patients with during
preconception counseling.
Keywords
Abbreviations:
MS (multiple sclerosis), EDSS (expanded disability status scale), BMI (body-mass index), DMT (disease-modifying therapy), ART (assisted reproductive technology), SGA (small for gestational age), BPD (biparietal diameter), HC (head circumference), AC (abdominal circumference), FL (femur length)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 31, 2022
Accepted:
July 31,
2022
Received in revised form:
July 22,
2022
Received:
May 27,
2022
Footnotes
☆This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
