Clinical Epidemiology (Mar 2023)

Maternal Multiple Sclerosis and Health Outcomes Among the Children: A Systematic Review

  • Andersen ML,
  • Jølving LR,
  • Stenager E,
  • Knudsen T,
  • Nørgård BM

Journal volume & issue
Vol. Volume 15
pp. 375 – 389

Abstract

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Mette Louise Andersen,1– 3 Line Riis Jølving,1,2 Egon Stenager,4,5 Torben Knudsen,4,6 Bente Mertz Nørgård1,2 1Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark; 2Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 3Department of Gynecology and Obstetrics, University Hospital of Southern Jutland, Esbjerg, Denmark; 4Department of Regional Research, University of Southern Denmark, Odense, Denmark; 5Multiple Sclerosis Clinic Hospital of Southern Jutland, Aabenraa, University of Southern Denmark, Odense, Denmark; 6Department of Gastroenterology, University Hospital of Southern Jutland, Esbjerg, DenmarkCorrespondence: Mette Louise Andersen, Center for Clinical Epidemiology, Odense University Hospital, Kloevervaenget 30, Entrance 216, Odense, DK- 5000, Denmark, Email [email protected]: To summarize the available literature and provide an overview of in utero exposure to maternal multiple sclerosis (MS) and the influence on offspring health outcomes.Methods: We conducted a systematic review by searching Embase, Medline and PubMed.gov databases, and we used covidence.org to conduct a thorough sorting of the articles into three groups; 1) women with MS and the influence on birth outcomes; 2) women with MS treated with disease-modifying therapy (DMT) during pregnancy and the influence on birth outcomes; and 3) women with MS and the influence on long-term health outcomes in the children.Results: In total, 22 cohort studies were identified. Ten studies reported on MS without DMT and compared with a control group without MS, and nine studies on women with MS and DMT prior to or during pregnancy met the criteria. We found only four studies reporting on long-term child health outcomes. One study had results belonging to more than one group.Conclusion: The studies pointed towards an increased risk of preterm birth and small for gestational age among women with MS. In terms of women with MS treated with DMT prior to or during pregnancy, no clear conclusions could be reached. The few studies on long-term child outcomes all had different outcomes within the areas of neurodevelopment and psychiatric impairment. In this systematic review, we have highlighted the research gaps on the impact of maternal MS on offspring health.Keywords: multiple sclerosis, pregnancy, neonatal outcomes, long-term health outcomes, reproduction

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