AAN 2022 | The protective effect of pregnancy in MS

During an interview at the American Academy of Neurology 2022 Congress in Seattle, WA, Kristen Krysko, MD, University of California San Francisco, San Francisco, CA, discussed the protected state that pregnancy confers regarding relapses of multiple sclerosis (MS), and the increased risk of relapse during the postpartum period. This has been documented since the 1990s, with a historical MR cohort study showing that the relapse rate and radiological activity increased postpartum for around three months. Since this study, other case series and cohort studies have replicated these findings. The few studies not to demonstrate this increase still showed a return to pre-pregnancy levels of disease activity. Although pregnancy usually comes with a reduction in relapses, Dr Krysko recognizes that rebound relapses can occur during this time because of the discontinuation of disease modifying therapies that must be stopped during pregnancy (e.g., S1P inhibitors).