Dr Manny's Notes

How multiple sclerosis affects pregnancy

Worldwide, MS may affect more than 2 million people.

Worldwide, MS may affect more than 2 million people.  (iStock)

People who deal with the debilitating effects of multiple sclerosis are strong and courageous. While some show few symptoms and can live a normal life, others deal with more severe effects like paralysis and impaired speech. Since women between ages 20–50 are the most likely to get MS, doctors expect some questions about pregnancy. How does MS affect pregnancy? Can MS patients have children?

For the most part, women dealing with MS can have children successfully. On the other hand, they should know more about treating MS outside of pregnancy first. Then, they can talk with their practitioners further before getting pregnant.

Breaking Treatment

If MS patients are not pregnant, they will usually take a round of drugs that slow down the disease’s effects. They may also take medicines to lessen painful symptoms.

While the usual drugs prescribed for MS help patients somewhat, they have not proven extremely effective. Recently, researchers have been studying and testing a new drug that will even help patients with severe MS.

These patients usually suffer debilitating symptoms that worsen over time, a form of MS called primary progressive. Until now, they had little hope of battling these severe effects.

Then last week, the US Food and Drug Administration approved the new drug, Ocrevus, for MS treatment. The drug works well in both severe and mild forms of MS, mainly because it focuses on the body’s B cells. Most other approved drugs suppress patients’ T cells instead.

Does this new treatment mean that MS patients will be healed? Unfortunately, no.

Still, the trials for Ocrevus have helped further knowledge about the disease. The new drug also offers hope to patients with severe MS because they previously had no approved medication.

What Is MS?

Worldwide, MS may affect more than 2 million people. Its often debilitating symptoms are caused by the body’s immune system attacking its nervous tissue. The disease has many causes and variables, but it can result in severe damage to the nervous system if left untreated.

Specifically, the body’s immune cells attack the protein myelin. This protein actually surrounds the nerve fibers that send electrical signals to other parts of the body.

When these fibers become damaged, a person may experience a wide array of symptoms. Patients may suffer from pain, vision or speech loss, lack of coordination, fatigue, and numbness or paralysis.

They can also have problems with memory and other cognitive functions. Because MS can impair so many abilities in a person, patients can find themselves quite limited in normal activities.

How Does MS Affect Pregnancy?

For years, many doctors advised MS patients not to have children, fearing that the disease would worsen with childbirth. Fortunately, science has proven otherwise. Many MS patients can have children successfully.

According to the National Multiple Sclerosis Society, MS has shown to have no negative effects on fertility and childbirth. In fact, patients in the second and third trimesters tend to have fewer relapses, probably because pregnancy causes more proteins and other immunosuppressants to circulate through the body.

While pregnancy may help MS patients have fewer relapses, the child-carrying can pronounce some symptoms. Patients already dealing with bowel dysfunction, loss of coordination and balance, fatigue, and trouble walking may experience worsened symptoms during pregnancy.

Also, most medicines prescribed for MS are not safe during pregnancy. In many cases, the patient can still succeed in having children by working closely with their doctors.

Postpartum and MS

The trouble with getting pregnant and having MS lies in the postpartum period. Mostly within the first six months of postpartum, 20–40 percent of MS patients will relapse. To further complicate postpartum, breastfeeding mothers cannot use most MS medications.

Mothers with MS may need to focus on resting during the first six months after birth, getting help in other daily activities. Aside from this increased relapse, though, mothers do not have a risk of worsening the disease due to pregnancy.

Overall, MS patients can have a safe and successful pregnancy despite their symptoms. With a doctor’s guidance, they can learn to cope with certain pronounced symptoms and may even find their MS improved because of pregnancy. Then, they can enjoy the smiles and cuddles that come with bringing a baby into the world.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.