Runmarker B, Andersen O
Department of Neurology, Sahlgrenska Hospital, Göteborg, Sweden.
Brain. 1995 Feb;118 ( Pt 1):253-61. doi: 10.1093/brain/118.1.253.
The effects of pregnancy were studied in a multiple sclerosis incidence cohort. In order to eliminate interaction bias between the disease and pregnancy, analysis of the risk of relapse during pregnancy and the puerperium was limited to the onset bout, using fecundity figures for Sweden. The risk of onset bout was significantly reduced during pregnancy while the risk of onset bout in the post-partum period did not differ significantly from the risk during non-pregnancy periods. We also found a decreased risk of multiple sclerosis onset in parous compared with nulliparous women. The association between nulliparity and multiple sclerosis tended to increase with age. Furthermore, the effect of pregnancy on the long-term prognosis in established multiple sclerosis was analysed by comparing the risk of change from a relapsing-remitting to a chronic progressive course and the risk of reaching level 6 of the Disability Status Scale in women with pregnancy after multiple sclerosis onset with that in non-pregnant control patients, matched for neurological deficit, disease duration and age. There was a significantly decreased risk of a progressive course in women who were pregnant after multiple sclerosis onset.
在一个多发性硬化症发病率队列中研究了妊娠的影响。为了消除疾病与妊娠之间的交互偏倚，使用瑞典的生育数据，将妊娠和产褥期复发风险的分析局限于首发发作。妊娠期间首发发作的风险显著降低，而产后首发发作的风险与非妊娠期间的风险无显著差异。我们还发现，经产妇患多发性硬化症的风险低于未产妇。未生育与多发性硬化症之间的关联往往随年龄增长而增加。此外，通过比较多发性硬化症发病后妊娠的女性与未妊娠对照患者（在神经功能缺损、病程和年龄方面匹配）从复发缓解型转变为慢性进展型的风险以及达到残疾状态量表6级的风险，分析了妊娠对已确诊的多发性硬化症长期预后的影响。多发性硬化症发病后妊娠的女性病情进展的风险显著降低。
