|
|
(HealthNewsDigest.com) – STANFORD, Calif. – Having multiple sclerosis or epilepsy doesn’t put a mother-to-be at significant risk for pregnancy-related problems, according to a new study by Stanford University School of Medicine researchers.
The work, based on a national patient database, represents the largest study to date of pregnant women with MS or epilepsy. It shows that women with the disorders face only a slightly elevated risk of abnormal fetal growth rate and cesarean section delivery, and are not more likely to have blood pressure problems or deliver prematurely.
“In general, the outcomes of pregnancy were not terribly different from those of healthy women,” said immunologist Eliza Chakravarty, MD, senior author of the study that appears in the Nov. 18 issue of Neurology, the medical journal of the American Academy of Neurology. “Hopefully this information will be reassuring to women and their physicians.”
MS and epilepsy are two of the most common, chronic neurologic disorders affecting women of childbearing age: 400,000 Americans are estimated to have MS, and the disease usually begins in women between the ages of 20 and 40. According to the Epilepsy Foundation, more than 1 million U.S. women and girls have epilepsy or other seizure disorders.
Because of concerns about their disease and the impact of medications on their fetuses, some women with chronic illness opt to delay or even avoid pregnancy. Chakravarty, an assistant professor of immunology and rheumatology, said she’s seen many patients who wanted children but were uncertain about outcomes or who were advised by their doctors not to become pregnant.
For all women with chronic disease, she added, “certain questions come up. ‘Will it be safe for me to have a baby? Will the baby be OK? What should I do about my medicine?'”
As the researchers point out in the paper, few studies have been done on pregnancy-related risks for women with these diseases. Chakravarty said most literature on MS, for example, has focused on the impact of pregnancy on disease activity, rather than on obstetric outcomes. “We know what pregnancy does to MS, but what does MS do to a pregnancy?” she said.
In 2005, Chakravarty published a paper showing that women with two other chronic illnesses, lupus and rheumatoid arthritis, were several times more likely than healthy women to develop hypertension and have c-sections or deliver prematurely. She wondered if pregnancy risks were similar in other diseases, and she launched this study to compare outcomes in women with MS and epilepsy to those of healthy women and women with diabetes, the most common chronic disease affecting women of childbearing age.
For the study, Chakravarty and her colleagues used the Nationwide Inpatient Sample, the country’s largest publicly available inpatient care database, to calculate the number of deliveries between 2003 and 2006. They then looked at pregnancy outcomes, which included length of hospital stay, c-section delivery and hypertensive disorders including pre-eclampsia, premature rupture of membranes and intrauterine growth restriction (a term used for fetuses that aren’t growing at a normal rate inside the uterus).
There were 18.8 million deliveries in the time period studied; out of these, 10,055 occurred in women with MS; 4,730 in those with epilepsy; and 187,239 in those with diabetes. Consistent with past studies, the researchers found that women with diabetes faced an increased risk of problems in all categories. The picture was rosier, though, for women with the other diseases.
After factoring for maternal age, race and ethnicity, the researchers found that MS and epilepsy were associated with mildly increased rates of c-section delivery (42.4 percent for women with MS and 44.5 percent for those with epilepsy, compared with 32.8 percent for healthy women) and abnormal fetal growth rate (2.7 percent for those with MS and 3.8 percent for those with epilepsy, compared with 1.9 percent for healthy women).
There wasn’t a significant difference between women with MS or epilepsy and healthy women in other outcomes, such as premature rupture of membranes (which can lead to early delivery) or hypertension – findings that Chakravarty said she was “very relieved to see.”
Chakravarty suspects the results will be comforting to women with MS or epilepsy who are expecting or are contemplating a future pregnancy. “You need to be watched more carefully, but the disease alone doesn’t put you in a super high-risk category,” she said. “Just having MS or epilepsy shouldn’t be a determining factor in whether you should have a baby.”
Despite the reassuring findings, there are limitations to this study. Chakravarty said that the researchers had no data on such things as prenatal care; use of medication, alcohol or tobacco; or duration and severity of underlying disease – all of which could impact outcomes.
Chakravarty’s Stanford colleagues on the study were internal medicine resident Victoria Kelly, MD, and Lorene Nelson, PhD, associate professor of health research and policy. There was no outside funding for the study.
The Stanford University School of Medicine consistently ranks among the nation’s top 10 medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://mednews.stanford.edu. The medical school is part of Stanford Medicine, which includes Stanford Hospital & Clinics and Lucile Packard Children’s Hospital. For information about all three, please visit http://stanfordmedicine.org/about/news.html.
Subscribe to our FREE Ezine and be eligible for Health News, discounted products/services and coupons related to your Health. We publish 24/7.
HealthNewsDigest.com
We videotape Press Conferences, produce SMT’s, VNR’s, B-rolls, PSA’s, – all with distribution: HealthyTelevisionProductions