☆ 4.7 Article

Menarche, pregnancies, and breastfeeding do not modify long-term prognosis in multiple sclerosis

NEUROLOGY (2019)

Journal

NEUROLOGY

Volume 92, Issue 13, Pages E1507-E1516

Publisher

LIPPINCOTT WILLIAMS & WILKINS

DOI: 10.1212/WNL.0000000000007178

Keywords

Funding

Ministry of Economy and Competitiveness of Spain [FIS PI15/0070]
Fundacion Genzyme
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Abstract

Objective To investigate the effect of menarche, pregnancies, and breastfeeding on the risk of developing multiple sclerosis (MS) and disability accrual using a multivariate approach based on a large prospective cohort of patients with clinically isolated syndrome (CIS). Methods A cross-sectional survey of the reproductive information of female participants in a CIS cohort was performed. We examined the relationship of age at menarche with the risk of clinically definite MS (CDMS), McDonald 2010 MS, and Expanded Disability Status Scale (EDSS) 3.0 and 6.0. The effect of pregnancy (before and after CIS) and breastfeeding in the risk of CDMS, McDonald 2010 MS, and EDSS 3.0 was also examined. Univariate and multivariate analyses were performed and findings were confirmed using sensitivity analyses and a propensity score model. Results The data of 501 female participants were collected. Age at menarche did not correlate with age at CIS and was not associated with the risk of CDMS or EDSS 3.0 or 6.0. Pregnancy before CIS was protective for CDMS in the univariate analysis, but the effect was lost in the multivariate model and did not modify the risk of EDSS 3.0. Pregnancy after CIS was protective for both outcomes in univariate and multivariate analyses when pregnancy was considered a baseline variable, but the protective effect disappeared when analyzed as a time-dependent event. Breastfeeding did not modify the risk for the 3 outcomes. Conclusions These results demonstrate that menarche, pregnancies, and breastfeeding did not substantially modify the risk of CDMS or disability accrual using a multivariable and time-dependent approach.

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Menopause does not modify disability trajectories in a longitudinal cohort of women with clinically isolated syndrome and multiple sclerosis followed from disease onset

Susana Otero-Romero, Luciana Midaglia, Pere Carbonell-Mirabent, Maria Zuluaga, Ingrid Galan, Jordi Rio, Georgina Arrambide, Marta Rodriguez-Barranco, Angela Vidal-Jordana, Joaquin Castillo, Breogan Rodriguez-Acevedo, Ana Zabalza, Carlos Nos, Manuel Comabella-Lopez, Patricia Mulero, Cristina Auger, Jaume Sastre-Garriga, Santiago Perez-Hoyos, Alex Rovira, Xavier Montalban, Mar Tintore

Summary: In this study, the effect of menopause on disability accumulation in women with clinically isolated syndrome (CIS) was evaluated. Results indicated that menopause did not increase the risk of disability in this population when considering Expanded Disability Status Scale (EDSS) trajectories along with age and disease duration. The annual increase in EDSS was higher in menopausal women compared to nonmenopausal women, but this difference disappeared when controlling for age and disease duration.

EUROPEAN JOURNAL OF NEUROLOGY (2022)