- Among women with clinically isolated syndrome (CIS), age at menarche, pregnancies, and breastfeeding did not modify long-term prognosis regarding multiple sclerosis (MS).
Why this matters
- Women are disproportionately affected by MS.
- Need for information to guide reproductive counseling.
- During a median 9.5-year follow-up:
- 53% developed clinically definite MS (CDMS).
- 61% met McDonald 2010 MS criteria.
- 13.4% and 2.6% reached Expanded Disability Status Scale (EDSS) 3.0 and 6.0, respectively.
- Age at menarche:
- Not correlated with age at CIS.
- Not associated with risk for CDMS or EDSS 3.0 or 6.0.
- Pregnancy before CIS:
- Reduced risk for CDMS in univariate but not multivariate analysis.
- Not associated with risk for EDSS 3.0.
- Pregnancy after CIS:
- Reduced risk for CDMS, EDSS 3.0 in multivariate analyses (HR, 0.25 [95% CI, 0.16-0.38] and HR, 0.45 [95% CI, 0.23-0.89], respectively) when pregnancy is a baseline variable.
- Did not reduce risk for either when pregnancy is a time-dependent variable.
- Breastfeeding did not significantly alter risk for any outcome.
- Spanish cross-sectional cohort study of 501 women with CIS.
- Reproductive history self-reported.
- Main outcomes: CDMS, McDonald 2010 MS, EDSS 3.0 and 6.0.
- Funding: Ministry of Economy and Competitiveness of Spain; others.
- Possible selection, recall biases.
- Potential residual, unmeasured confounding.