Pregnancy and multiple sclerosis.
MS is an unpredictable, potentially disabling condition that occurs most commonly in women of reproductive age. The decision to have a baby after this diagnosis is a difficult and very personal one. Each couple considering a family deserves preconception counseling with accurate information and support to facilitate an informed decision. Consistently, studies have found that pregnancy is a period of safety from worsening of MS but that exacerbation occurs at two to three times the expected rate after delivery. Gestational history does not seem to affect the ultimate prognosis of the disease. The decision to bear children then seems to depend first on the desire of the woman to have a family. Additional issues to consider for a woman with MS considering pregnancy are current physical impairment and support available from father, family, and friends. There is considerable evidence that some protective factor exists during pregnancy to cause the disease to be less active. Presumably, this is a soluble factor or factors that suppress the cellular immune system. This is of great potential scientific interest, since it may contribute to our understanding of MS and potentially lead to newer avenues of research and treatment.