Pfeffer Lena Kristina, Ramien Caren, Harrison Anja, Patas Kostas, Grentzenberg Kristina, Reinhardt Stefanie, Mönch Andrea, Kaufmann Max, Gold Stefan M, Heesen Christoph
Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Front Neurol. 2025 Jul 15;16:1619021. doi: 10.3389/fneur.2025.1619021. eCollection 2025.
Since multiple sclerosis (MS) primarily affects women of childbearing age, the disease intersects with a critical period for family planning and pregnancy. This is important, since pregnancy itself can influence psychological well-being, contributing to symptoms such as depression, stress and fatigue. However, while mental health during late pregnancy and the postpartum period has been studied in women with multiple sclerosis (wwMS), data on longitudinally tracking mental health in wwMS across all trimesters of pregnancy are still limited.
In this prospective cohort study, we assessed the frequency and severity of depression, stress and fatigue in 95 women with relapsing-remitting MS (RRMS) throughout the course of pregnancy and postpartum using a set of psychological questionnaires. Furthermore, we evaluated the frequency and disease-specific risk factors of postpartum depression.
Over the course of pregnancy, there was no relevant increase in depressive symptoms, fatigue or stress. Moderate to high risk of postpartum depression was evident in 19.8% of wwMS and positively correlated with an increase in Expanded Disability Status Scale (EDSS) ( = 0.237, = 0.049) during pregnancy but not with baseline EDSS.
Our data suggest that pregnancy does not generally increase the risk of stress, depression, or fatigue in wwMS, which is reassuring for both wwMS and their treating physicians. However, given the higher susceptibility to mental health alterations in MS, regular screening for mental health disturbances remains crucial. In particular, wwMS with disability progression during pregnancy should be closely monitored for postpartum depression.
由于多发性硬化症（MS）主要影响育龄女性，该疾病与计划生育和怀孕的关键时期相互交织。这一点很重要，因为怀孕本身会影响心理健康，导致抑郁、压力和疲劳等症状。然而，虽然已对患有多发性硬化症的女性（wwMS）怀孕晚期和产后的心理健康进行了研究，但关于纵向跟踪wwMS整个孕期心理健康的数据仍然有限。
在这项前瞻性队列研究中，我们使用一套心理问卷评估了95例复发缓解型多发性硬化症（RRMS）女性在整个孕期和产后抑郁、压力和疲劳的频率及严重程度。此外，我们评估了产后抑郁的频率和疾病特异性风险因素。
在整个孕期，抑郁症状、疲劳或压力没有相关增加。19.8%的wwMS存在中度至高度产后抑郁风险，且与孕期扩展残疾状态量表（EDSS）增加呈正相关（ = 0.237， = 0.049），但与基线EDSS无关。
我们的数据表明，怀孕一般不会增加wwMS出现压力、抑郁或疲劳的风险，这对wwMS及其治疗医生来说都是令人安心的。然而，鉴于MS患者心理健康改变的易感性较高，定期筛查心理健康障碍仍然至关重要。特别是，孕期残疾进展的wwMS应密切监测产后抑郁情况。
