Key clinical point : Most women diagnosed with multiple sclerosis (MS) can have children without incurring an increased risk of relapses and should be encouraged to breastfeed exclusively as this lowers the risk of postpartum relapses.
Major finding : The annualized relapse rates (ARRs) declined from 0.37 before pregnancy to 0.14 during pregnancy ( P less than .0001), with no rebound disease activity in the postpartum period. ARR was found to be 0.27 at 3 months postpartum and 0.37 at 4-6 months, matching prepregnancy rates. Exclusive breastfeeding for at least 2 months after delivery reduced the risk of relapse in the first 6 months postpartum (adjusted hazard ratio, 0.37; P = .0093).
Study details : This study evaluated the electronic health records of 466 pregnancies among 375 women with MS and their infants at the Kaiser Permanente Southern and Northern California between 2008 and 2016.
Disclosures: This study was supported by the National Multiple Sclerosis Society. Annette Langer-Gould has received grant support and awards from the NIH, the Patient-Centered Outcomes Research Institute, and the National MS Society; and currently serves as a voting member on the California Technology Assessment Forum, a core program of the Institute for Clinical and Economic Review (ICER). She has received sponsored and reimbursed travel from the ICER. The remaining authors declared no conflict of interest.
Citation: Langer-Gould A et al. Neurology. 2020 Apr 13. doi: 10.1212/WNL.0000000000009374.