Birk K, Smeltzer S C, Rudick R
Department of Obstetrics and Gynecology, Genesee Hospital, Rochester, New York.
Semin Neurol. 1988 Sep;8(3):205-13. doi: 10.1055/s-2008-1041379.
MS is an unpredictable, potentially disabling condition that occurs most commonly in women of reproductive age. The decision to have a baby after this diagnosis is a difficult and very personal one. Each couple considering a family deserves preconception counseling with accurate information and support to facilitate an informed decision. Consistently, studies have found that pregnancy is a period of safety from worsening of MS but that exacerbation occurs at two to three times the expected rate after delivery. Gestational history does not seem to affect the ultimate prognosis of the disease. The decision to bear children then seems to depend first on the desire of the woman to have a family. Additional issues to consider for a woman with MS considering pregnancy are current physical impairment and support available from father, family, and friends. There is considerable evidence that some protective factor exists during pregnancy to cause the disease to be less active. Presumably, this is a soluble factor or factors that suppress the cellular immune system. This is of great potential scientific interest, since it may contribute to our understanding of MS and potentially lead to newer avenues of research and treatment.
多发性硬化症是一种不可预测的、可能导致残疾的疾病，最常见于育龄女性。确诊后决定生育是一个艰难且非常个人化的决定。每对考虑要孩子的夫妇都应该接受孕前咨询，获得准确的信息和支持，以便做出明智的决定。一直以来，研究发现怀孕期是多发性硬化症病情不会恶化的安全时期，但产后病情加重的发生率是预期的两到三倍。妊娠史似乎并不影响该疾病的最终预后。那么，是否生育的决定似乎首先取决于女性想要组建家庭的愿望。对于考虑怀孕的多发性硬化症女性来说，其他需要考虑的问题包括当前的身体损伤以及来自孩子父亲、家人和朋友的支持。有大量证据表明，孕期存在某种保护因素，可使病情不那么活跃。据推测，这是一种或多种抑制细胞免疫系统的可溶性因素。这具有极大的潜在科学价值，因为它可能有助于我们理解多发性硬化症，并可能带来新的研究和治疗途径。
