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Parity is associated with a longer time to reach irreversible disability milestones in women with multiple sclerosis.
Masera, S; Cavalla, P; Prosperini, L; Mattioda, A; Mancinelli, C R; Superti, G; Chiavazza, C; Vercellino, M; Pinessi, L; Pozzilli, C.
Afiliación
  • Masera S; MS Centre, Department of Neuroscience, University of Turin & City of Health and Science University Hospital of Turin, Italy.
  • Cavalla P; MS Centre, Department of Neuroscience, University of Turin & City of Health and Science University Hospital of Turin, Italy paola.cavalla@unito.it.
  • Prosperini L; Department of Neurology and Psychiatry, Sapienza University, Rome, Italy.
  • Mattioda A; MS Centre, Department of Neuroscience, University of Turin & City of Health and Science University Hospital of Turin, Italy.
  • Mancinelli CR; Department of Neurology and Psychiatry, Sapienza University, Rome, Italy.
  • Superti G; MS Centre, Department of Neuroscience, University of Turin & City of Health and Science University Hospital of Turin, Italy.
  • Chiavazza C; MS Centre, Department of Neuroscience, University of Turin & City of Health and Science University Hospital of Turin, Italy.
  • Vercellino M; MS Centre, Department of Neuroscience, University of Turin & City of Health and Science University Hospital of Turin, Italy.
  • Pinessi L; MS Centre, Department of Neuroscience, University of Turin & City of Health and Science University Hospital of Turin, Italy.
  • Pozzilli C; Department of Neurology and Psychiatry, Sapienza University, Rome, Italy.
Mult Scler ; 21(10): 1291-7, 2015 Sep.
Article en En | MEDLINE | ID: mdl-25533293
BACKGROUND: Multiple sclerosis (MS) frequently affects women of childbearing age. While short-term effects of pregnancy on MS course are well-known, whether pregnancy may influence long-term disability progression is debated. METHODS: A two-centre retrospective study to investigate long-term effect of pregnancy on disability was performed in a population of MS women. Survival analyses and multivariate Cox proportional regression models (including early predictors of MS severity and exposure to disease-modifying treatments) were performed to compare time to reach well-established disability milestones in nulliparous women and in those with pregnancies after MS onset ('parous'). Women with pregnancies before MS onset were excluded from analyses as they represent a heterogeneous group. RESULTS: Data about 445 women (261 nulliparous, 184 'parous') were analysed. A longer time to reach Expanded Disability Status Scale (EDSS) 4.0 and 6.0 was observed in parous women; Cox regression models revealed a lower risk for 'parous' than nulliparous women in reaching EDSS 4.0 and 6.0 (HR = 0.552, p = 0.008 and HR = 0.422, p = 0.012 respectively). CONCLUSION: Our findings suggest that pregnancy after MS onset is associated with a slower long-term disability progression. Whether this represents a biological/immunological effect, or reflects a higher propensity toward childbearing in women with milder disease, it remains uncertain deserving further investigations.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Paridad / Personas con Discapacidad / Evaluación de la Discapacidad / Esclerosis Múltiple Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Mult Scler Asunto de la revista: NEUROLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Paridad / Personas con Discapacidad / Evaluación de la Discapacidad / Esclerosis Múltiple Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Mult Scler Asunto de la revista: NEUROLOGIA Año: 2015 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido