Pregnancy and multiple sclerosis (MS)

Pregnancy is something that many women with MS have thought about or experienced, as MS often first affects women when they are of childbearing age. There is no evidence that having MS will affect your fertility, lead to an increased number of complications during pregnancy, or your baby’s health; however, being pregnant with MS can have unique challenges in addition to your usual maternal concern for the health of your baby. Make sure that your healthcare provider is aware that you have MS, and that he or she is communicating with your neurologist.

Does pregnancy make MS worse?

In most cases, pregnancy does not make MS symptoms worse. In fact, women often find that MS relapses occur less frequently during pregnancy, especially in their second and third trimesters.

During the first 3 to 6 months after giving birth, some women may experience a worsening or relapse of their MS symptoms.

Being pregnant can also make some existing symptoms of MS more difficult to cope with, such as any bladder and bowel problems and fatigue (tiredness). Women may notice their center of gravity shift as they gain weight, which can increase any existing problems with balance and worsen unsteadiness when walking. As symptoms of MS can make childcare challenging, there is an added complication of having to think ahead about how they will look after children in the future. However, planning ahead with the help of friends, family, and their healthcare providers can help women with MS who are interested in having a family.

Is my baby at risk of getting MS?

A common concern for expectant parents with MS is that their child may be more likely to be diagnosed with MS. MS is not classed as a genetic (inherited) condition, as there has not been one specific gene identified that causes it. However, family studies indicate that children who have a family member with MS are slightly more likely to develop MS than children who do not have a family member with MS. For example, the average person in the USA has a 1 in 750 chance of developing MS. This means that for every 750 people, 1 person will develop MS. For someone with a close relative, such as a parent or sibling, with MS, the chance of developing MS rises to between 1 out of 40 and 1 out of 100. A healthcare provider will be able to explain these risks to you in more detail.

How will MS treatment affect my baby?

All pregnant women are advised to think carefully about any substances (e.g. foods, drinks, and medicines) they put into their body. This is because some substances can move from the mother’s bloodstream directly to the baby’s bloodstream (through the placenta). It is important to discuss all medicines that you are taking with your healthcare provider when you are pregnant, including herbal medicines. Your healthcare provider will weigh the risks and benefits of any medicines that you are currently taking to help you decide what to receive during your pregnancy.

In many cases, when a mother receives a medicine, the effect of that medicine on the health of babies is unknown. This is because pregnant women are not usually included in clinical research studies where potential new medicines are being tested. Pregnancy registries are designed to help healthcare providers learn more about medicines and their effects on babies. The aim is to provide women and their healthcare providers with information to help them make informed decisions in the future about their treatment during pregnancy. It is not known if OCREVUS^® (ocrelizumab) will harm your unborn baby.

Learn about the OCREVUS Pregnancy Registry here

Where can I go for help and advice?

Your healthcare team should be the first source of information about pregnancy and MS. In addition, there are many MS societies where you can seek help and advice from people who have experience with MS and pregnancy. Your healthcare provider may be able to help you contact a society that is active in your local area.