Andersen Johanna Balslev, Kopp Tine Iskov, Sellebjerg Finn, Magyari Melinda
Department of Neurology (JBA, TIK), The Danish Multiple Sclerosis Registry, University of Copenhagen; and Department of Neurology (FS, MM), The Danish Multiple Sclerosis Center, University of Copenhagen, Denmark.
Neurol Clin Pract. 2021 Aug;11(4):280-290. doi: 10.1212/CPJ.0000000000001035. Epub 2021 Feb 3.
To investigate differences in pregnancy-related and perinatal outcomes in women with multiple sclerosis (MS) compared with the general population.
We conducted a cross-sectional study including pregnancies from January 1, 1997, to December 31, 2016, to women registered in the Danish Multiple Sclerosis Registry (the study cohort). Pregnancy-related and perinatal outcomes were compared with a randomly selected subcohort of pregnancies from the general population (the comparison cohort) using logistic regression adjusted for possible confounders.
In total, 2,930 pregnancies were included in the study cohort and 56,958 pregnancies in the comparison cohort. No differences were found in pregnancy-related complications (preeclampsia/gestational diabetes or placenta complications), emergency caesarean section (c-section), instrumental delivery, low Apgar score, stillbirth, preterm birth, or congenital malformations. Elective c-section (odds ratio [OR] 1.89 [95% confidence interval (CI) 1.65-2.16]), induced delivery (OR 1.15 [95% CI 1.01-1.31]), and being born small for gestational age (SGA) (OR 1.29 [95 %CI 1.04-1.60]) had a higher prevalence in the study cohort, whereas the prevalence of signs indicating asphyxia was lower in the study cohort (OR 0.87 [95% CI 0.78-0.97]) relative to the comparison cohort.
We found a higher prevalence of elective c-sections, induced delivery, and infants being SGA among newborns to women with MS, whereas the prevalence of asphyxia was lower in the study cohort. There were no significant differences in severe adverse perinatal outcomes when comparing women with MS and their newborns with those of the general population.
调查多发性硬化症（MS）女性与普通人群在妊娠相关及围产期结局方面的差异。
我们开展了一项横断面研究，纳入了1997年1月1日至2016年12月31日在丹麦多发性硬化症登记处登记的女性所怀的妊娠（研究队列）。使用经可能的混杂因素调整的逻辑回归，将妊娠相关及围产期结局与从普通人群中随机选取的妊娠亚队列（对照队列）进行比较。
研究队列共纳入2930例妊娠，对照队列纳入56958例妊娠。在妊娠相关并发症（先兆子痫/妊娠期糖尿病或胎盘并发症）、急诊剖宫产、器械助产、低阿氏评分、死产、早产或先天性畸形方面未发现差异。择期剖宫产（比值比[OR]1.89[95%置信区间（CI）1.65 - 2.16]）、引产（OR 1.15[95% CI 1.01 - 1.31]）以及小于胎龄儿（SGA）出生（OR 1.29[95% CI 1.04 - 1.60]）在研究队列中的患病率较高，而相对于对照队列，研究队列中提示窒息的体征患病率较低（OR 0.87[95% CI 0.78 - 0.97]）。
我们发现MS女性所生新生儿中择期剖宫产、引产及小于胎龄儿的患病率较高，而研究队列中窒息的患病率较低。将MS女性及其新生儿与普通人群的女性及其新生儿进行比较时，严重不良围产期结局无显著差异。
