Pregnancy in multiple sclerosis in Baghdad 2024: a case control study

Background: Multiple sclerosis (MS) is an inflammatory demyelination illness affecting the central nervous system, with a higher prevalence in women, especially in childbearing age. Objectives of the study to measure pregnancy-related complications for both MS women and their newborns, to determine pregnancy's impact on MS relapses, and to evaluate the impact of disease-modifying therapies. Methods: A case-control study that included 265 women with MS and their 265 matched controls. The study was conducted at Baghdad teaching hospital, medical city health directorate, and the AL-Saidyia primary health care center. All information was collected through the direct interviews by using a pre-prepared questionnaire from 15th March to December 2024; odds ratio (OR) was calculated, and a class interval that does not contain 1 is considered statistically significant. Results: Pregnancy-related complications were reported in 27.5% of cases and 19.6% of controls. Miscarriages were significantly more common in the MS group (12.3% vs. 1.9%, OR 7.2, CI 2.78-18.89). Infants reported a total complication of 13.3% vs. 7.8%, with low birth weight (17%) as the most common complication in fetuses who were born to women with MS. Breastfeeding was less common in MS mothers (9.8% vs. 20.7%, p=0.001). Only 10.2% of MS patients continued disease modifying therapies (DMTs) (interferon beta) during pregnancy, with no significant link to adverse outcomes. Conclusions: Pregnant women with MS and their fetuses experienced more complications like a higher rate of miscarriages and low birth weight. Interferons are not associated with adverse pregnancy outcomes. Multidisciplinary prenatal, natal, and postnatal care is essential for women with MS.