Investigators sought to determine relapse rates of multiple sclerosis decrease prior to pregnancy, during pregnancy, and postpartum.
Relapses of multiple sclerosis decrease during pregnancy, increase 6 weeks postpartum, and decrease 6 to 12 months postpartum, according to a study published in Neurology.
Researchers in this retrospective study evaluated data from women (N=2158) who were diagnosed with multiple sclerosis from the IQVIA Real-World Data Adjudicated Claims–US database to analyze the frequency of multiple sclerosis relapses and the use of disease-modifying drugs before pregnancy, during pregnancy, and postpartum. Relapses were defined as a multiple sclerosis-related hospitalization, emergency department visit, or an outpatient visit with a corticosteroid prescription. Disease-modifying drugs could include self-injectables, oral medications, or infusions.
When compared with before pregnancy, the odds of relapse during pregnancy decreased (OR 0.623; 95% CI, 0.521-0.744, P <.0001), while the odds of relapse during the first 6 weeks postpartum increased (OR 1.710; 95% CI, 1.358-2.152, P <.0001) and the odds of relapse during the last 3 postpartum quarters increased (OR 1.216; 95% CI, 1.052-1.406, P =.0081). Overall, most relapses were treated at an outpatient facility, and relapses treated during an emergency department visit remained constant throughout the study time frame (P >.05). The odds of a relapse requiring hospitalization were the highest during the third trimester (OR 1.849; 95% CI, 1.280-2.670, P =.0011) and the first 6 weeks after delivery (OR 2.315; 95% CI, 1.478-3.626, P=.0002). Disease-modifying drug treatment remained low during pregnancy and 6 weeks postpartum but increased significantly by 12 months post pregnancy (OR 1.259; 95% CI, 1.156-1.371, P <.0001). At 12 months post pregnancy, 28.5% of patients initiated disease-modifying drugs, with 47.8% of these occurring by 90-days post delivery.