Multiple Sclerosis and Its Link With Pregnancy and Breastfeeding

How Are Multiple Sclerosis and Pregnancy Related?

Previously, it was thought that women with multiple sclerosis (MS) should not go for childbearing, but recent studies have disproved this thought. It was found that MS patients can get pregnant, and it does not increase the risk of complications of pregnancy.

It was also found that MS can not be passed on to the child from the parent through pregnancy or breastfeeding, but the risk of developing the disease from a parent is only about 2 percent. Family planning can help determine the best time to get pregnant, whether to have one or two children, and whether to breastfeed. All this information should be discussed with the neurologist and gynecologist.

During pregnancy, the immune system changes and does not attack the developing baby. These changes can even alter the symptoms of MS. As a result, many individuals with MS have shown a reduction in their symptoms during pregnancy. This even reduced the relapse of MS in the postpartum period. These changes may differ from one person to another.

Does Having MS Affect Women’s Fertility?

According to the studies, MS does not directly affect women’s fertility; in fact, the pregnancy rate is similar among women with or without MS. However, when considering the risks of pregnancy with multiple sclerosis, a few factors should be noted

• Symptoms of MS can affect the ability to conceive.

• A few medications of disease-modifying therapies (DMTs) may affect fertility by impacting ovulation (release of egg from the ovary).

Therefore, MS does not directly affect fertility, but the severity and treatments may impact it. Additionally, like any other disease, stress levels, overall health, and age may influence fertility.

What Are the Symptoms of MS That Can Occur in Women During Pregnancy?

Symptoms of MS that can occur in women during pregnancy include:

• Fatigue: This is very common in the early stages of pregnancy.

• Bowel and Bladder Issues: Symptoms like urgency and increased frequency of urination can occur due to pressure from the uterus on the bladder. UTIs (urinary tract infections) are also common during pregnancy.

• Mobility Issues: This can worsen in the later stages of pregnancy, requiring a cane or other walking aids.

• Constipation: This can be relieved with stool softeners.

• Heat Sensitivity: Heat sensitivity may increase during pregnancy.

After giving birth, the disease flare-ups may increase, which is called postpartum relapse, and require constant monitoring and medications to manage symptoms.

What Complications Can MS Cause During Pregnancy?

Most of the studies have shown that women usually feel well during pregnancy and experience no new problems. However, understanding whether multiple sclerosis can worsen during pregnancy is important, as MS can make pregnancy more difficult; some complications include:

• Relapses of the disease are less frequent during pregnancy. However, the relapses increase after giving birth. However, studies have shown that exclusive breastfeeding can reduce relapses.

• Fatigue is a common symptom of MS and pregnancy. Therefore, fatigue is more severe during pregnancy in MS women, making it more difficult to manage.

• A few medications used in treating MS can cause issues during conception and pregnancy. Therefore, it is important to take the advice of healthcare providers.

• MS can cause muscle weakness, heat sensitivity, mobility issues, and bowel and bladder issues, which can be aggravated during pregnancy, making it more difficult.

• Pregnancy can cause emotional changes, and MS can further worsen mental health.

• Symptoms of MS may affect pelvic muscles and nerves, which may lead to trouble in pushing out the baby during delivery.

• Women affected by MS are more likely to undergo a cesarean surgery when compared to healthy women. The reason is that MS symptoms cause muscle problems, which delay labor.

MS does not increase risks such as stillbirth, congenital disabilities, and miscarriage. According to a study conducted in 2021, it was found that complications do not differ for those with MS when compared to those without MS. The condition did not increase the risk for emergency cesarean surgery, gestational diabetes, preeclampsia, or placenta issues.

Is It Possible to Have a Healthy Pregnancy and Birth With MS?

Yes, a person with MS can have a healthy pregnancy and birth with the help of the right medical care.

But some factors have to be considered, such as:

• Pregnancy does not worsen the MS disease; in fact, there may be a reduction in symptoms of MS during early pregnancy. However, flare-ups can occur after giving birth.

• Some medications that are used for MS treatment are not safe.

• A few symptoms of MS may exacerbate during pregnancy.

• Because of mobility issues, most women undergo cesarean sections.

Is It Possible to Breastfeed While Living With MS?

While there are considerations and potential challenges for breastfeeding with MS, it is generally possible to breastfeed successfully and safely (because MS cannot pass through breast milk).

Here are a few considerations:

• The safety of MS medications during breastfeeding varies depending on the specific medication. Some medications can pass into breast milk, while others have limited data on their transfer.

• Pregnancy and the postpartum period can impact MS disease activity. While some studies show no significant benefit, some suggest that breastfeeding may protect against postpartum relapses.

• MS symptoms, such as mobility issues and fatigue, can make breastfeeding difficult.

What Is the Management of MS in a Breastfeeding Woman?

The management of multiple sclerosis in a breastfeeding woman requires careful consideration to balance the well-being of both the mother and the baby.

Here are some general guidelines for managing MS while breastfeeding:

• When breastfeeding, it is important to choose MS medications that have minimal transfer into breast milk. Injectable forms of Interferon-beta (for example, interferon-beta-1a, interferon-beta-1b) and Glatiramer acetate are generally considered to have low levels of transfer into breast milk.

• Continue regular check-ups with a healthcare provider to monitor MS symptoms, disease activity, and overall well-being.

• Maintain a healthy lifestyle that includes a balanced diet, regular exercise, adequate rest, and stress management.

Conclusion:

Multiple sclerosis usually does not affect pregnancy and breastfeeding. Most women with MS may have healthy kids. However, managing MS during breastfeeding or pregnancy requires continuous monitoring, lifestyle changes, and individualized treatment strategies. Hence, it becomes important to know about MS, its symptoms, problems related to pregnancy among those with MS, and the effects of MS and pregnancy on each other. If you have MS and are planning to get pregnant or need any kind of information, talk to our obstetrician and gynecologist at iCliniq.

Key Takeaways:

• Many women with MS can have healthy babies. When they are pregnant, their MS often gets calmer. But after the baby is born, their MS symptoms may act up again, particularly in the first three to six months after delivery.

• According to studies, breastfeeding is also considered safe for MS individuals by reducing the risk of postpartum relapse by up to 48 percent.