Disease Activity And Its Association With Breastfeeding In Multiple Sclerosis Patients During Postpartum Period

Abstract

Background: The post-partum period may represent a difficult phase in multiple sclerosis (MS) course, as
during the first three months after delivery, a disease worsening is possible, particularly in women with a
more active disease and multiple relapses that occurred prior to the pregnancy. Aim of the work: This study aimed to investigate the association between breastfeeding and disease activity of MS during postpartum period. Patients and methods: A retrospective observational study was conducted on 113 MS women following 136 pregnancies occurred after MS diagnosis and with history of at least one pregnancy during the last seven years. The archived files and a self-administrating questionnaire were used for data collection. Results: Disease modifying therapy (DMT) usage and disease duration did not show any significant association with disease activity. While, number of postpartum relapses was significantly related to exclusive breastfeeding (OR=0.31, 95%CI: 0.12–0.67, P=0.02). Furthermore, the pregnancy and pre-pregnancy relapses were significant predictors for postpartum relapses (OR=3.09, 95%CI: 1.68–5.67, P<0.001, and OR=2.21, 95%CI: 1.23–3.69, P=0.005, respectively). Conclusions: Postpartum reactivation of the disease occurs from the third month after labor rather than the early postpartum period. Exclusive breastfeeding for at least two months decreased the risk of postpartum relapse.