Grant: Operating Grant

Multiple Sclerosis (MS) is a relatively common disease of the brain and spinal cord, leading to disability and coordination problems; its cause is unknown. Women and men are often diagnosed with MS just as they are considering starting a family, making pregnancy-related issues of great importance. Historically, women with MS were advised against pregnancy because of assumed adverse effects on the course of their MS disease. We now know that short-term benefits can be gained during pregnancy, but it is unclear whether long-term benefits also occur in MS. We will examine the effect of pregnancy on long-term disability outcomes in MS. The need for pre-pregnancy planning is also important in MS, particularly since the introduction of new drugs for MS, such as the beta-interferons (IFNB). We will investigate the effect of MS on delivery and the newborn and how the newborn might be influenced by IFNB treatment. Fathers are often neglected in pregnancy studies; we will explore how IFNB treatment in fathers with MS might impact the newborn. Given the estimated 75,000 Canadians with MS, the relatively young age at MS onset and the increasing popularity of the MS drugs; issues surrounding pregnancy and MS and a possible negative effect of MS drugs on pregnancy are of real importance. This research will link, for the first time, extensive province-wide databases related to MS and pregnancy, enabling data collected by specialist physicians for over two decades to be examined. To date, there have been few studies as comprehensive as ours investigating all these aspects of pregnancy in MS. In addition, this important information will help develop a framework to evaluate the risk of future new MS drugs on pregnancy and may also have implications for other patient groups using similar drugs (the interferons), such as hepatitis C. Our study is a cost-effective way of spending research dollars, costing the equivalent of placing just 5 people with MS on IFNB treatment for 5 years.