Customize Consent Preferences

We use cookies to help you navigate efficiently and perform certain functions. You will find detailed information about all cookies under each consent category below.

The cookies that are categorized as "Necessary" are stored on your browser as they are essential for enabling the basic functionalities of the site. ... 

Always Active

Necessary cookies are required to enable the basic features of this site, such as providing secure log-in or adjusting your consent preferences. These cookies do not store any personally identifiable data.

No cookies to display.

Functional cookies help perform certain functionalities like sharing the content of the website on social media platforms, collecting feedback, and other third-party features.

No cookies to display.

Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics such as the number of visitors, bounce rate, traffic source, etc.

No cookies to display.

Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

No cookies to display.

Advertisement cookies are used to provide visitors with customized advertisements based on the pages you visited previously and to analyze the effectiveness of the ad campaigns.

No cookies to display.


Home > Neurology > AAN 2019 > Multiple Sclerosis and NMOSD > No increased MS relapse risk postpartum

No increased MS relapse risk postpartum

Expert
Dr Annette Langer-Gould, Kaiser Permanente Southern California, Pasadena, USA
Conference
AAN 2019
    “Women with MS should be allowed to breastfeed.” Dr Annette Langer-Gould (Kaiser Permanente Southern California, Pasadena, USA) said she has spent the better part of the last 15 years on this matter.

    In a plenary review session, she said an increased relapse risk in the first 3 months postpartum was found in a well-known study by Confavreux et al. [1], but this was before disease-modifying treatments were available and before MRI scans could help diagnose MS after just one attack. Dr Langer-Gould initiated a study to see if the relapse risk in the early postpartum period is still augmented today [2].

    She identified 466 pregnancies among 375 women with MS and fond no rebound disease activity directly after giving birth. “This is likely due to the inclusion of women from a population-based setting and of women diagnosed after a single relapse, and high rates of exclusive breastfeeding.” Of the participants, 38.0% were not on any treatment in the year prior to conception, 14.6% had clinically isolated syndrome and 8.4% relapsed during pregnancy. In the postpartum year, 26.4% relapsed and 41.2% resumed disease-modifying treatments. Annualised relapse rates declined from 0.39 pre-pregnancy to 0.14-0.07 (P<0.0001) during pregnancy. In the first 3 months postpartum, annualised relapse rate was 0.27 (P=0.02), and returned to pre-pregnancy rates (0.37) at 4-6 months.

    Dr Langer-Gould was “pleasantly surprised” to find that 87% breastfed and 35% breastfed exclusively. Exclusive breastfeeding reduced the risk of postpartum relapses (adjusted HR 0.58; P=0.01), but resuming modestly effective disease-modifying treatments had no effect. “Times have changed”, she concluded. In her opinion, advising against breastfeeding because of MS is overly conservative and unnecessary.

    1. Confavreux C, et al. N Engl J Med. 1998;339(5):285-91.
    2. Langer-Gould A, et al. AAN 2019, S6.007.



    Posted on