Study finds pregnancy can delay onset of MS symptoms

A Monash-led international study has found that pregnancy can delay the onset of multiple sclerosis (MS) symptoms by more than three years.

Using the global MSBase database of more than 70,000 MS patients, the study examined whether pregnancy had any impact on the onset of their first attack of neurological symptoms, known as ‘clinically isolated syndrome’. The study found that women with previous pregnancies and childbirths had a later onset of clinically isolated syndrome compared with women who had never been pregnant.

Led by Dr Vilija Jokubaitis from the Monash University Department of Neuroscience, the study — published in JAMA Neurology — looked at whether pregnancy can delay the onset of MS, which is very frequently diagnosed in women of childbearing years.

Dr Jokubaitis studied more than 3600 women attending four MS clinics in two countries (Czech Republic and Australia), all of whom were enrolled in MSBase.

The study found that women who have been pregnant were diagnosed with their first MS symptoms, on average, 3.3 years later than women who had never been pregnant. A similar delay in MS onset was also observed in women who had carried a baby to term — with onset delayed by an average of 3.4 years.

Dr Jokubaitis explained that pregnancy could reduce the abnormal overactivity of the immune system that causes MS, potentially long term.

“At present we don’t know exactly how pregnancy slows the development of MS, but we believe that it has to do with alterations made to a woman’s DNA. We are now seeking funding opportunities to explore this exciting possibility,” she said.

The MSBase Neuro-Immunology Registry has been following patients with MS from 35 countries since 2001, becoming an Australian not-for-profit foundation in 2004. The registry is managed by Professor Helmut Butzkueven, Chair of the Multiple Sclerosis and Neuroimmunology research unit in Monash University’s Department of Neuroscience.

Discussing the findings published in JAMA Neurology, Professor Butzkueven said the data provides a big-picture view of MS causes and helps clinicians decide on the best treatment strategies to prevent long-term disability in MS.

“Many of our huge questions need 10 years or more to get the answers, and only long-term systematic registry datasets like MSBase, with buy-in from tens of thousands of patients, can do this,” he said.

The enormous data within MSBase contains information on the onset of disease, the long- and short-term effects of new and existing treatments, relapses and disability levels of each patient over time, all of which has been made available in over 50 peer-reviewed publications.

According to Professor Butzkueven, very large datasets like those within MSBase are important to determine the long-term benefits and risks of treatments as well as enabling insights into an individual’s likely disease course.

MSBase is currently building a revolutionary new care and research platform.

“The big challenge in MS is having treatments to stop and reverse the progressive phase of MS,” Professor Butzkueven said.

“We need new biomarkers of progression to build cheap, effective and fast trials of the future. The MSBase Registry and Monash University are now partnering strategically to make this a reality.”

Dr Julia Morahan, Head of Research at MS Research Australia, said, “With the incidence of MS increasing, especially in women, it is great to see Australian researchers investigating factors that might contribute to the development of MS in women and further delineating the relationship between pregnancy and MS onset.”

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