Maternal Multiple Sclerosis and Health Outcomes Among the Children: A Systematic Review

Mette Louise Andersen; Line Riis Jølving; Egon Stenager; Torben Knudsen; Bente Mertz Nørgård

doi:10.2147/CLEP.S392273

Maternal Multiple Sclerosis and Health Outcomes Among the Children: A Systematic Review

Clin Epidemiol. 2023 Mar 19:15:375-389. doi: 10.2147/CLEP.S392273. eCollection 2023.

Authors

Mette Louise Andersen^{1

2

3}, Line Riis Jølving^{1

2}, Egon Stenager^{4

5}, Torben Knudsen^{4

6}, Bente Mertz Nørgård^{1

2}

Affiliations

¹ Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
² Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
³ Department of Gynecology and Obstetrics, University Hospital of Southern Jutland, Esbjerg, Denmark.
⁴ Department of Regional Research, University of Southern Denmark, Odense, Denmark.
⁵ Multiple Sclerosis Clinic Hospital of Southern Jutland, Aabenraa, University of Southern Denmark, Odense, Denmark.
⁶ Department of Gastroenterology, University Hospital of Southern Jutland, Esbjerg, Denmark.

Abstract

Objective: To summarize the available literature and provide an overview of in utero exposure to maternal multiple sclerosis (MS) and the influence on offspring health outcomes.

Methods: We conducted a systematic review by searching Embase, Medline and PubMed.gov databases, and we used covidence.org to conduct a thorough sorting of the articles into three groups; 1) women with MS and the influence on birth outcomes; 2) women with MS treated with disease-modifying therapy (DMT) during pregnancy and the influence on birth outcomes; and 3) women with MS and the influence on long-term health outcomes in the children.

Results: In total, 22 cohort studies were identified. Ten studies reported on MS without DMT and compared with a control group without MS, and nine studies on women with MS and DMT prior to or during pregnancy met the criteria. We found only four studies reporting on long-term child health outcomes. One study had results belonging to more than one group.

Conclusion: The studies pointed towards an increased risk of preterm birth and small for gestational age among women with MS. In terms of women with MS treated with DMT prior to or during pregnancy, no clear conclusions could be reached. The few studies on long-term child outcomes all had different outcomes within the areas of neurodevelopment and psychiatric impairment. In this systematic review, we have highlighted the research gaps on the impact of maternal MS on offspring health.

Keywords: long-term health outcomes; multiple sclerosis; neonatal outcomes; pregnancy; reproduction.

Publication types

Review

Grants and funding

This work has been supported by Region of Southern Denmark [grant no. 20/14788, 2022], Odense University Hospital [grant no. 122-A5119 and 128-A5300, 2021], Jascha Foundation [grant no. 3630, 2020], Consultant Schou and Wife Else-Marie Schou, born Wanges Foundation [grant no. 85832].