Open AccessImmunomodulation and postpartum relapses in patients with multiple sclerosis
Author(s) -
Kerstin Hellwig,
Christian Beste,
Sebastian Schimrigk,
Andrew T. Chan
Publication year - 2009
Publication title -
therapeutic advances in neurological disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.684
H-Index - 50
eISSN - 1756-2864
pISSN - 1756-2856
DOI - 10.1177/1756285608100416
Subject(s) - medicine , pregnancy , multiple sclerosis , observational study , postpartum period , obstetrics , immunology , genetics , biology
Multiple sclerosis (MS) mainly affects young women during a life period with desire for children. Relapse rate decreases during pregnancy and rises after delivery. Therefore, studies on satisfactory postpartum relapse prevention and its efficacy are essential. Previous smaller and uncontrolled studies suggested that intravenous immunoglobulin (IVIG) administration reduced the relapse rate following delivery. The objective of our observational study was to compare the efficacy of IVIG application, treatment with other immunomodulatory compounds or no treatment at all on the postpartal relapse rate in female MS patients from our pregnancy database. One hundred and twenty four pregnancies were followed in a partly prospective design. Relapse rate was reduced during pregnancy (p<0.001) and increased during the initial 3 months after delivery in all MS patients (p<0.001). The relapse rate reduction showed only a trend in favour of the IVIG-treated women, probably due to the small number of patients. However, analysing the expected number of relapses, IVIG treated patients had significantly less relapses postpartum than the untreated control group matched for disease activity before and during pregnancy (χ 2 , p = 0.013). The results suggest that IVIG could be an option to prevent postpartum relapse of MS.