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Can Life Events Affect the Course of MS?

While there is no good evidence that daily stress or trauma
affects the course of MS, there is data on the influence of
pregnancy. Since MS generally strikes during childbearing years,
a common concern among women with the disease is whether or not
to have a baby. Studies on the subject have shown that MS has no
adverse effects on the course of pregnancy, labor, or delivery;
in fact symptoms often stabilize or remit during pregnancy. This
temporary improvement is thought to relate to changes in a
woman's immune system that allow her body to carry a baby:
because every fetus has genetic material from the father as well
as the mother, the mother's body should identify the growing
fetus as foreign tissue and try to reject it in much the same
way the body seeks to reject a transplanted organ. To prevent
this from happening, a natural process takes place to suppress
the mother's immune system in the uterus during pregnancy.
However, women with MS who are considering pregnancy need to
be aware that certain drugs used to treat MS should be avoided
during pregnancy and while breast feeding. These drugs can cause
birth defects and can be passed to the fetus via blood and to an
infant via breast milk. Among them are
prednisone,
corticotropin, azathioprine, cyclophosphamide, diazepam, phenytoin, carbamazepine, and baclofen.
Unfortunately, between 20 and 40 percent of women with MS do
have a relapse in the three months following delivery. However,
there is no evidence that pregnancy and childbirth affect the
overall course of the disease one way or the other. Also, while
MS is not in itself a reason to avoid pregnancy and poses no
significant risks to the fetus, physical limitations can make
child care more difficult. It is therefore important that MS
patients planning families discuss these issues with both their
partner and physician.
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