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Depressed Pregnant Women at Greater Risk from Flu Infection
 October 28th, 2009  
Pregnant women with significant symptoms of depression tend to have a stronger biological reaction to the seasonal flu vaccine than do women with lower depression levels, according to a new study.
An internal inflammatory response to vaccination is not uncommon — it’s an essential part of the process the immune system initiates to prepare for a successful fight against an actual infection. But it’s also expected to be a weak and brief response.
“Inflammatory responses to vaccination do no harm, are mild, and typically go away within a few days. But an extended inflammatory response to vaccination, such as the one seen in women with the most depressive symptoms, isn’t expected, and it serves as a way to estimate how somebody might respond to an actual infection or illness,” said Lisa Christian, an assistant professor of psychiatry at Ohio State University and lead author of the research.
She and colleagues also recently published a study in the same journal indicating that pregnant women experiencing depressive symptoms and certain stressors had higher levels of inflammatory markers in their blood than did pregnant women with lower depression and stress levels.
Though this mind-body connection is well established in people with chronic stress, Christian said few studies have examined the effects of depression and stress during pregnancy. Research has shown that pregnancy suppresses certain functions of the immune system to prevent rejection of the fetus and to protect the fetus from inflammation that accompanies fevers and other illnesses.
In the flu vaccine study, 22 pregnant women completed questionnaires about their depressive symptoms and gave blood samples before they received a seasonal influenza shot. Between six and nine days later, a second round of blood samples was collected.
Researchers assessed the women’s depressive symptoms using the Center for Epidemiologic Studies Depression Scale, a series of 20 questions about physical, emotional and cognitive symptoms. The women were classified in three groups: having either no or minimal depression; mild or moderate depressive symptoms; and significant depressive symptoms. A diagnosis of depression can be made only after an interview with a doctor.
The scientists analyzed the post-vaccination blood samples for the presence of macrophage migration inhibitory factor, or MIF, a protein that promotes inflammation by suppressing other substances in the blood that fight inflammation.
A week after receiving the flu shots, the women with the highest scores on the depression scale had about twice as much MIF in their blood as did women reporting minimal symptoms.
Christian’s previous study on inflammatory markers in the blood during pregnancy involved 60 women, including the 22 who participated in the flu study.
In this study, researchers assessed the women using a variety of measures: the depressive symptom scale, a perceived stress scale measuring experiences of stress and coping with stress in the past month; a questionnaire gauging how much social support the women had; tests for frequency of stressful social interactions; and a short survey of how happy the women and their partners were about the pregnancy.
Blood samples were taken to measure levels of two proteins, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a). Both are proinflammatory cytokines, chemical messengers that are mobilized when the body is injured or has an infection, and they cause inflammation in their effort to make repairs in the body.
When these proteins circulate without an infection to fight, the body experiences excess inflammation, which is associated with a variety of diseases depending on which cells are producing the proteins. Previous studies have shown that such inflammation during pregnancy can increase the risk of preterm birth and preeclampsia, a high blood pressure condition that can occur during the last half of pregnancy.
Overall, the women reporting more depressive symptoms had significantly higher levels of IL-6 in their blood than did women with fewer symptoms. The association between depressive symptoms and TNF-a was not as strong, but was still considered significant.
In both studies, the researchers assessed a variety of health behaviors and measures, such as body mass index, cigarette smoking, prenatal vitamin use and physical activity, to gauge whether these factors might affect the presence of inflammation markers. None of the measures had a significant effect, Christian said.
Source
Related
- Depressed Pregnant Women at Greater Risk from Flu Infection
Pregnant women with significant symptoms of depression tend to have a stronger biological reaction to the seasonal flu vaccine than do women with lower depression levels, according to a new study.
An internal inflammatory response to vaccination is not uncommon — it’s an essential part of the process the immune system initiates to prepare for a successful fight against an actual infection. But it’s also expected to be a weak and brief response.
“Inflammatory responses to vaccination do no harm, are mild, and typically go away within a few days. But an extended inflammatory response to vaccination, such as the one seen in women with the most depressive symptoms, isn’t expected, and it serves as a way to estimate how somebody might respond to an actual infection or illness,” said Lisa Christian, an assistant professor of psychiatry at Ohio State University and lead author of the research.
She and colleagues also recently published a study in the same journal indicating that pregnant women experiencing depressive symptoms and certain stressors had higher levels of inflammatory markers in their blood than did pregnant women with lower depression and stress levels.
Though this mind-body connection is well established in people with chronic stress, Christian said few studies have examined the effects of depression and stress during pregnancy. Research has shown that pregnancy suppresses certain functions of the immune system to prevent rejection of the fetus and to protect the fetus from inflammation that accompanies fevers and other illnesses.
In the flu vaccine study, 22 pregnant women completed questionnaires about their depressive symptoms and gave blood samples before they received a seasonal influenza shot. Between six and nine days later, a second round of blood samples was collected.
Researchers assessed the women’s depressive symptoms using the Center for Epidemiologic Studies Depression Scale, a series of 20 questions about physical, emotional and cognitive symptoms. The women were classified in three groups: having either no or minimal depression; mild or moderate depressive symptoms; and significant depressive symptoms. A diagnosis of depression can be made only after an interview with a doctor.
The scientists analyzed the post-vaccination blood samples for the presence of macrophage migration inhibitory factor, or MIF, a protein that promotes inflammation by suppressing other substances in the blood that fight inflammation.
A week after receiving the flu shots, the women with the highest scores on the depression scale had about twice as much MIF in their blood as did women reporting minimal symptoms.
Christian’s previous study on inflammatory markers in the blood during pregnancy involved 60 women, including the 22 who participated in the flu study.
In this study, researchers assessed the women using a variety of measures: the depressive symptom scale, a perceived stress scale measuring experiences of stress and coping with stress in the past month; a questionnaire gauging how much social support the women had; tests for frequency of stressful social interactions; and a short survey of how happy the women and their partners were about the pregnancy.
Blood samples were taken to measure levels of two proteins, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a). Both are proinflammatory cytokines, chemical messengers that are mobilized when the body is injured or has an infection, and they cause inflammation in their effort to make repairs in the body.
When these proteins circulate without an infection to fight, the body experiences excess inflammation, which is associated with a variety of diseases depending on which cells are producing the proteins. Previous studies have shown that such inflammation during pregnancy can increase the risk of preterm birth and preeclampsia, a high blood pressure condition that can occur during the last half of pregnancy.
Overall, the women reporting more depressive symptoms had significantly higher levels of IL-6 in their blood than did women with fewer symptoms. The association between depressive symptoms and TNF-a was not as strong, but was still considered significant.
In both studies, the researchers assessed a variety of health behaviors and measures, such as body mass index, cigarette smoking, prenatal vitamin use and physical activity, to gauge whether these factors might affect the presence of inflammation markers. None of the measures had a significant effect, Christian said.
Source
- Low Choline Levels in Pregnant Women Raise Babies’ Risk for Brain and Spinal-Cord Defects
A newborn’s risk for brain and spinal-cord defects rises if the mother has low blood levels of the nutrient choline during pregnancy, researchers at the Stanford University School of Medicine have discovered.
The scientists used a collection of 180,000 blood samples from pregnant California women to look for risk factors for two neural tube birth defects: anencephaly, a lethal condition in which the brain and skull do not develop, and spina bifida, a spinal-cord malformation that causes paralysis and lifelong disability. Neural tube defects have become less common since the 1996 decision to fortify the U.S. food supply with folic acid, a B-vitamin shown to prevent the defects, but they have not disappeared.
“Families whose infants die or suffer permanent disability from NTDs still feel the burden of these defects,” said Gary Shaw, DrPH, professor of neonatology and primary author of the new research, which will appear Aug. 14 in Epidemiology.
About 500 pregnancies per year are affected by neural tube defects in California alone, noted Shaw. “We’re keen on understanding what risk factors explain the continued disease.”
Shaw’s study targeted a group of nutrients suspected to promote brain and spinal-cord development. In early pregnancy, a sealed tube forms along the embryo’s back that later grows into the brain and spinal cord. Neural tube defects occur if the tube does not seal correctly. Based on prior research on folic acid, scientists believe that development of the neural tube may depend on a specific biochemical pathway that requires several vitamins and essential nutrients to operate properly. Shaw’s team measured blood levels of 13 of these nutrients in two groups of women who participated in California’s prenatal birth-defect screening program.
From 180,000 pregnant women screened between 2003 and 2005, the researchers identified 80 whose pregnancies were affected by neural tube defects. Their blood samples were compared to 409 samples randomly selected from among the women whose infants had no structural birth defects.
Choline, an essential nutrient found in egg yolks, soy, wheat germ and meats, was the only nutrient measured whose blood levels were linked to risk of neural tube defects.
“As choline levels went up, risk went down,” Shaw said. Risk for neural tube defects was 2.4 times higher in women with the lowest blood choline levels compared to women with average blood choline levels. The highest blood choline levels were associated with the lowest risk. A previous study by Shaw’s group showed that consumption of choline-rich foods was associated with lower risk for neural tube defects, but this is the first study to evaluate blood levels of choline and NTD risk.
Shaw cautioned that the blood samples tested were obtained between the 15th and 18th week of pregnancy, well after formation of the neural tube, which seals around the sixth week of pregnancy. Future research will be needed to examine blood choline levels in early pregnancy, he said. Researchers also need to test whether choline supplements given in early pregnancy reduce the rates of neural tube defects. Right now, prenatal multivitamins contain little or no choline.
Source
- Massage Reduces Depression in Pregnant Women
New research shows massage therapy reduced depression in pregnant women, and also reduced the incidence of massaged women’s babies being born prematurely.
The study was conducted by researchers at the Touch Research Institutes, where pioneering research about massage has been conducted since 1992.
Pregnant women diagnosed with major depression were given 12 weeks of massage, twice per week, by their significant other. A control group did not receive massage, according to an abstract published on www.pubmed.gov.
The massage-therapy group versus the control group not only had reduced depression by the end of the massage-therapy period, they also had reduced depression and cortisol levels during the postpartum period.
The massaged women’s newborns were also less likely to be born prematurely and low birthweight, pubmed noted, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.
Source
- Stress, Anxiety Can Up Risk of Depression in Pregnancy
Stress, history of depression, lack of social support and unintended pregnancy are among the major factors that contribute to increased risk of depression in pregnant women, a new study shows.
Other important factors are maternal anxiety, domestic violence and having public insurance coverage, said the University of Michigan researchers, who reviewed 159 studies conducted between 1980 and 2008.
The study appears in the January issue of the American Journal of Obstetrics & Gynecology.
Depression, which occurs in about 12.7 percent of pregnant women, can cause problems for mothers and babies, including pre-term delivery, preeclampsia, sleep disturbances and disrupted mother-infant bonding.
It’s important for physicians to know how to identify depression in pregnant women, said the study authors, who noted that not all women who test positive on depression screening tests have or will develop clinical depression.
“We are hoping that [health-care] providers can use the presence or absence of risk factors such as those identified in our study to enhance their assessments for depression in addition to the information they obtain from the screening test,” study author Dr. Christie A. Lancaster, a clinical lecturer in the obstetrics and gynecology department at U-M, said in a news release.
Source
- Pregnant Women With MS Have Good Outcomes
Good news for women with multiple sclerosis (MS) who are pregnant or thinking about becoming pregnant. A study published Wednesday shows that while women with MS have a somewhat heightened risk of certain pregnancy complications, by and large, their pregnancies are as healthy as other women’s.
Using a national database on nearly 19 million deliveries in the U.S., researchers found that women with MS had marginally higher risks of cesarean delivery and intrauterine growth restriction — where a newborn’s weight is below the 10th percentile for his or her gestational age.
Among more than 10,000 women with MS who gave birth between 2003 and 2006, 42 percent had a C-section, compared with roughly 33 percent of women overall. Meanwhile, intrauterine growth restriction was seen in almost 3 percent, versus 2 percent of other women. Still, the overall findings, published in the medical journal Neurology, are being seen as good news for women with MS — a disorder that is more prevalent among women of childbearing age than any other group.
MS is believed to arise from an abnormal immune system attack on the body’s own myelin, a protective sheath surrounding nerve fibers in the brain and spine. This leads to symptoms such as muscle weakness, numbness, vision problems and difficulty with coordination and balance.
Years ago, women with MS were advised to avoid pregnancy, out of concern that it could exacerbate the disease. But studies in recent decades have shown that the opposite is true; many women see a remission in their symptoms during pregnancy — possibly because immune system activity naturally declines and levels of anti-inflammatory corticosteroids naturally rise during pregnancy.
The current study included information on 10,055 pregnant women with MS, as well as 4,730 with epilepsy and 187,239 with diabetes — two disorders already associated with higher risks of certain pregnancy complications.
Overall, women with either MS or epilepsy had elevated risks of C-section delivery and intrauterine growth restriction compared with U.S. women overall. They did, however, generally fare better than women with diabetes, who had higher rates of additional complications, like high blood pressure and premature rupture of the sac surrounding the fetus.
Women who are planning on becoming pregnant also need to talk with their doctors about whether they should stop taking any of their MS medications. It is not known whether the so-called disease-modifying drugs often used for MS are safe during pregnancy, and research suggests that at least one — beta-interferon — may be associated with miscarriage.
Chakravarty noted that the drug methotrexate, sometimes used for MS, is known to cause birth defects.
Source
Depressed Pregnant Women at Greater Risk from Flu Infection
October 28th, 2009
Pregnant women with significant symptoms of depression tend to have a stronger biological reaction to the seasonal flu vaccine than do women with lower depression levels, according to a new study.
An internal inflammatory response to vaccination is not uncommon — it’s an essential part of the process the immune system initiates to prepare for a successful fight against an actual infection. But it’s also expected to be a weak and brief response.
“Inflammatory responses to vaccination do no harm, are mild, and typically go away within a few days. But an extended inflammatory response to vaccination, such as the one seen in women with the most depressive symptoms, isn’t expected, and it serves as a way to estimate how somebody might respond to an actual infection or illness,” said Lisa Christian, an assistant professor of psychiatry at Ohio State University and lead author of the research.
She and colleagues also recently published a study in the same journal indicating that pregnant women experiencing depressive symptoms and certain stressors had higher levels of inflammatory markers in their blood than did pregnant women with lower depression and stress levels.
Though this mind-body connection is well established in people with chronic stress, Christian said few studies have examined the effects of depression and stress during pregnancy. Research has shown that pregnancy suppresses certain functions of the immune system to prevent rejection of the fetus and to protect the fetus from inflammation that accompanies fevers and other illnesses.
In the flu vaccine study, 22 pregnant women completed questionnaires about their depressive symptoms and gave blood samples before they received a seasonal influenza shot. Between six and nine days later, a second round of blood samples was collected.
Researchers assessed the women’s depressive symptoms using the Center for Epidemiologic Studies Depression Scale, a series of 20 questions about physical, emotional and cognitive symptoms. The women were classified in three groups: having either no or minimal depression; mild or moderate depressive symptoms; and significant depressive symptoms. A diagnosis of depression can be made only after an interview with a doctor.
The scientists analyzed the post-vaccination blood samples for the presence of macrophage migration inhibitory factor, or MIF, a protein that promotes inflammation by suppressing other substances in the blood that fight inflammation.
A week after receiving the flu shots, the women with the highest scores on the depression scale had about twice as much MIF in their blood as did women reporting minimal symptoms.
Christian’s previous study on inflammatory markers in the blood during pregnancy involved 60 women, including the 22 who participated in the flu study.
In this study, researchers assessed the women using a variety of measures: the depressive symptom scale, a perceived stress scale measuring experiences of stress and coping with stress in the past month; a questionnaire gauging how much social support the women had; tests for frequency of stressful social interactions; and a short survey of how happy the women and their partners were about the pregnancy.
Blood samples were taken to measure levels of two proteins, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a). Both are proinflammatory cytokines, chemical messengers that are mobilized when the body is injured or has an infection, and they cause inflammation in their effort to make repairs in the body.
When these proteins circulate without an infection to fight, the body experiences excess inflammation, which is associated with a variety of diseases depending on which cells are producing the proteins. Previous studies have shown that such inflammation during pregnancy can increase the risk of preterm birth and preeclampsia, a high blood pressure condition that can occur during the last half of pregnancy.
Overall, the women reporting more depressive symptoms had significantly higher levels of IL-6 in their blood than did women with fewer symptoms. The association between depressive symptoms and TNF-a was not as strong, but was still considered significant.
In both studies, the researchers assessed a variety of health behaviors and measures, such as body mass index, cigarette smoking, prenatal vitamin use and physical activity, to gauge whether these factors might affect the presence of inflammation markers. None of the measures had a significant effect, Christian said.
Source
Related
- Depressed Pregnant Women at Greater Risk from Flu Infection
Pregnant women with significant symptoms of depression tend to have a stronger biological reaction to the seasonal flu vaccine than do women with lower depression levels, according to a new study.
An internal inflammatory response to vaccination is not uncommon — it’s an essential part of the process the immune system initiates to prepare for a successful fight against an actual infection. But it’s also expected to be a weak and brief response.
“Inflammatory responses to vaccination do no harm, are mild, and typically go away within a few days. But an extended inflammatory response to vaccination, such as the one seen in women with the most depressive symptoms, isn’t expected, and it serves as a way to estimate how somebody might respond to an actual infection or illness,” said Lisa Christian, an assistant professor of psychiatry at Ohio State University and lead author of the research.
She and colleagues also recently published a study in the same journal indicating that pregnant women experiencing depressive symptoms and certain stressors had higher levels of inflammatory markers in their blood than did pregnant women with lower depression and stress levels.
Though this mind-body connection is well established in people with chronic stress, Christian said few studies have examined the effects of depression and stress during pregnancy. Research has shown that pregnancy suppresses certain functions of the immune system to prevent rejection of the fetus and to protect the fetus from inflammation that accompanies fevers and other illnesses.
In the flu vaccine study, 22 pregnant women completed questionnaires about their depressive symptoms and gave blood samples before they received a seasonal influenza shot. Between six and nine days later, a second round of blood samples was collected.
Researchers assessed the women’s depressive symptoms using the Center for Epidemiologic Studies Depression Scale, a series of 20 questions about physical, emotional and cognitive symptoms. The women were classified in three groups: having either no or minimal depression; mild or moderate depressive symptoms; and significant depressive symptoms. A diagnosis of depression can be made only after an interview with a doctor.
The scientists analyzed the post-vaccination blood samples for the presence of macrophage migration inhibitory factor, or MIF, a protein that promotes inflammation by suppressing other substances in the blood that fight inflammation.
A week after receiving the flu shots, the women with the highest scores on the depression scale had about twice as much MIF in their blood as did women reporting minimal symptoms.
Christian’s previous study on inflammatory markers in the blood during pregnancy involved 60 women, including the 22 who participated in the flu study.
In this study, researchers assessed the women using a variety of measures: the depressive symptom scale, a perceived stress scale measuring experiences of stress and coping with stress in the past month; a questionnaire gauging how much social support the women had; tests for frequency of stressful social interactions; and a short survey of how happy the women and their partners were about the pregnancy.
Blood samples were taken to measure levels of two proteins, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a). Both are proinflammatory cytokines, chemical messengers that are mobilized when the body is injured or has an infection, and they cause inflammation in their effort to make repairs in the body.
When these proteins circulate without an infection to fight, the body experiences excess inflammation, which is associated with a variety of diseases depending on which cells are producing the proteins. Previous studies have shown that such inflammation during pregnancy can increase the risk of preterm birth and preeclampsia, a high blood pressure condition that can occur during the last half of pregnancy.
Overall, the women reporting more depressive symptoms had significantly higher levels of IL-6 in their blood than did women with fewer symptoms. The association between depressive symptoms and TNF-a was not as strong, but was still considered significant.
In both studies, the researchers assessed a variety of health behaviors and measures, such as body mass index, cigarette smoking, prenatal vitamin use and physical activity, to gauge whether these factors might affect the presence of inflammation markers. None of the measures had a significant effect, Christian said.
Source
- Low Choline Levels in Pregnant Women Raise Babies’ Risk for Brain and Spinal-Cord Defects
A newborn’s risk for brain and spinal-cord defects rises if the mother has low blood levels of the nutrient choline during pregnancy, researchers at the Stanford University School of Medicine have discovered.
The scientists used a collection of 180,000 blood samples from pregnant California women to look for risk factors for two neural tube birth defects: anencephaly, a lethal condition in which the brain and skull do not develop, and spina bifida, a spinal-cord malformation that causes paralysis and lifelong disability. Neural tube defects have become less common since the 1996 decision to fortify the U.S. food supply with folic acid, a B-vitamin shown to prevent the defects, but they have not disappeared.
“Families whose infants die or suffer permanent disability from NTDs still feel the burden of these defects,” said Gary Shaw, DrPH, professor of neonatology and primary author of the new research, which will appear Aug. 14 in Epidemiology.
About 500 pregnancies per year are affected by neural tube defects in California alone, noted Shaw. “We’re keen on understanding what risk factors explain the continued disease.”
Shaw’s study targeted a group of nutrients suspected to promote brain and spinal-cord development. In early pregnancy, a sealed tube forms along the embryo’s back that later grows into the brain and spinal cord. Neural tube defects occur if the tube does not seal correctly. Based on prior research on folic acid, scientists believe that development of the neural tube may depend on a specific biochemical pathway that requires several vitamins and essential nutrients to operate properly. Shaw’s team measured blood levels of 13 of these nutrients in two groups of women who participated in California’s prenatal birth-defect screening program.
From 180,000 pregnant women screened between 2003 and 2005, the researchers identified 80 whose pregnancies were affected by neural tube defects. Their blood samples were compared to 409 samples randomly selected from among the women whose infants had no structural birth defects.
Choline, an essential nutrient found in egg yolks, soy, wheat germ and meats, was the only nutrient measured whose blood levels were linked to risk of neural tube defects.
“As choline levels went up, risk went down,” Shaw said. Risk for neural tube defects was 2.4 times higher in women with the lowest blood choline levels compared to women with average blood choline levels. The highest blood choline levels were associated with the lowest risk. A previous study by Shaw’s group showed that consumption of choline-rich foods was associated with lower risk for neural tube defects, but this is the first study to evaluate blood levels of choline and NTD risk.
Shaw cautioned that the blood samples tested were obtained between the 15th and 18th week of pregnancy, well after formation of the neural tube, which seals around the sixth week of pregnancy. Future research will be needed to examine blood choline levels in early pregnancy, he said. Researchers also need to test whether choline supplements given in early pregnancy reduce the rates of neural tube defects. Right now, prenatal multivitamins contain little or no choline.
Source
- Massage Reduces Depression in Pregnant Women
New research shows massage therapy reduced depression in pregnant women, and also reduced the incidence of massaged women’s babies being born prematurely.
The study was conducted by researchers at the Touch Research Institutes, where pioneering research about massage has been conducted since 1992.
Pregnant women diagnosed with major depression were given 12 weeks of massage, twice per week, by their significant other. A control group did not receive massage, according to an abstract published on www.pubmed.gov.
The massage-therapy group versus the control group not only had reduced depression by the end of the massage-therapy period, they also had reduced depression and cortisol levels during the postpartum period.
The massaged women’s newborns were also less likely to be born prematurely and low birthweight, pubmed noted, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.
Source
- Stress, Anxiety Can Up Risk of Depression in Pregnancy
Stress, history of depression, lack of social support and unintended pregnancy are among the major factors that contribute to increased risk of depression in pregnant women, a new study shows.
Other important factors are maternal anxiety, domestic violence and having public insurance coverage, said the University of Michigan researchers, who reviewed 159 studies conducted between 1980 and 2008.
The study appears in the January issue of the American Journal of Obstetrics & Gynecology.
Depression, which occurs in about 12.7 percent of pregnant women, can cause problems for mothers and babies, including pre-term delivery, preeclampsia, sleep disturbances and disrupted mother-infant bonding.
It’s important for physicians to know how to identify depression in pregnant women, said the study authors, who noted that not all women who test positive on depression screening tests have or will develop clinical depression.
“We are hoping that [health-care] providers can use the presence or absence of risk factors such as those identified in our study to enhance their assessments for depression in addition to the information they obtain from the screening test,” study author Dr. Christie A. Lancaster, a clinical lecturer in the obstetrics and gynecology department at U-M, said in a news release.
Source
- Pregnant Women With MS Have Good Outcomes
Good news for women with multiple sclerosis (MS) who are pregnant or thinking about becoming pregnant. A study published Wednesday shows that while women with MS have a somewhat heightened risk of certain pregnancy complications, by and large, their pregnancies are as healthy as other women’s.
Using a national database on nearly 19 million deliveries in the U.S., researchers found that women with MS had marginally higher risks of cesarean delivery and intrauterine growth restriction — where a newborn’s weight is below the 10th percentile for his or her gestational age.
Among more than 10,000 women with MS who gave birth between 2003 and 2006, 42 percent had a C-section, compared with roughly 33 percent of women overall. Meanwhile, intrauterine growth restriction was seen in almost 3 percent, versus 2 percent of other women. Still, the overall findings, published in the medical journal Neurology, are being seen as good news for women with MS — a disorder that is more prevalent among women of childbearing age than any other group.
MS is believed to arise from an abnormal immune system attack on the body’s own myelin, a protective sheath surrounding nerve fibers in the brain and spine. This leads to symptoms such as muscle weakness, numbness, vision problems and difficulty with coordination and balance.
Years ago, women with MS were advised to avoid pregnancy, out of concern that it could exacerbate the disease. But studies in recent decades have shown that the opposite is true; many women see a remission in their symptoms during pregnancy — possibly because immune system activity naturally declines and levels of anti-inflammatory corticosteroids naturally rise during pregnancy.
The current study included information on 10,055 pregnant women with MS, as well as 4,730 with epilepsy and 187,239 with diabetes — two disorders already associated with higher risks of certain pregnancy complications.
Overall, women with either MS or epilepsy had elevated risks of C-section delivery and intrauterine growth restriction compared with U.S. women overall. They did, however, generally fare better than women with diabetes, who had higher rates of additional complications, like high blood pressure and premature rupture of the sac surrounding the fetus.
Women who are planning on becoming pregnant also need to talk with their doctors about whether they should stop taking any of their MS medications. It is not known whether the so-called disease-modifying drugs often used for MS are safe during pregnancy, and research suggests that at least one — beta-interferon — may be associated with miscarriage.
Chakravarty noted that the drug methotrexate, sometimes used for MS, is known to cause birth defects.
Source
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