Investigation of pregnancy tendency, reproductive characteristics, and disability in women with multiple sclerosis: A secondary data analysis  of the national registry in Iran

Sajjad Ghane  Ezabadi; Fereshteh  Ashtari; Seyed Mohammad  Baghbanian; Nastaran  Majdi-Nasab; Elham  Madreseh; Hamidreza  Hatamian; Fardin  Faraji; Asghar  Bayati; Hoda  Kamali; Ehsan  Sharifipour; Hossein  Mozhdehipanah; Mohammad Amin Shahrbaf; Saeideh  Ayoubi; Mohammad Ali  Sahraian; Sharareh  Eskandarieh

doi:10.18502/cjn.v23i2.16839

Sajjad Ghane Ezabadi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Fereshteh Ashtari Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Seyed Mohammad Baghbanian Department of Neurology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Nastaran Majdi-Nasab Musculoskeletal Rehabilitation Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran
Elham Madreseh Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Hamidreza Hatamian Department of Neurology, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran
Fardin Faraji Department of Neurology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
Asghar Bayati Department of Neurology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
Hoda Kamali Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
Ehsan Sharifipour Department of Neurology, School of Medicine, Qom University of Medical Sciences, Qom, Iran
Hossein Mozhdehipanah 12 Department of Neurology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
Mohammad Amin Shahrbaf School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Saeideh Ayoubi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Ali Sahraian Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Sharareh Eskandarieh Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/cjn.v23i2.16839

Keywords: Multiple Sclerosis; Pregnancy; Parity; Abortion; Disability; Iran

Abstract

Abstract

Background: Multiple sclerosis (MS) predominantly affects women of childbearing age, significantly impacting their quality of life (QOL).The diagnosis of MS can influence pregnancy intention, and the level of disability associated with MS may change before and after pregnancy. This study aims to analyze the reproductive characteristics of Iranian female patients with MS (PwMS) and their association with the Expanded Disability Status Scale (EDSS) and pregnancy tendency, providing valuable insights into disease progression and the development of tailored treatments.

Methods: A cross-sectional study was conducted using data from the nationwide MS registry of Iran (NMSRI) from 2018 to 2021. Patients without a documented history of pregnancy, MS type, or EDSS score were excluded from the study. Various statistical methods, including nonparametric tests, the generalized estimating equation (GEE) model, and multiple logistic regression, were employed to analyze the data.

Results: The study included 1120 PwMS with a median diagnostic age of 31 and a disease duration of 6 years. The majority had relapsing-remitting MS (RRMS) and the mean EDSS score at bassline was 1.5 ± 1.4. A history of pregnancy or abortion was associated with higher EDSS scores. Multiparity before MS diagnosis was linked to EDSS score ≥ 5, while this EDSS range was associated with decreased parity after MS diagnosis (all P-values < 0.05).

Conclusion: Pregnancy and parity can affect the disability in female PwMS irrespective of clinical symptoms, diagnosis age, and MS type. Moreover, the chance of parity may be affected by a higher disability score, which should be considered in the clinical setting.