Pregnancy and multiple sclerosis: clinical issues.

Multiple sclerosis (MS) is the most common chronic disabling neurological d isease affecting young women. Paradoxically, our knowledge of the relations hip between pregnancy and MS is limited. However, several conclusions emerg e from the literature: 1) The rate of relapse in MS decreases during pregna ncy, and it rises significantly during the first three months post partum b efore coming back to its level prior to pregnancy. 2) Although pregnancy an d delivery cause changes of the relapse rate, they have no influence on mid and long term residual disability. 3) Breast-feeding and epidural analgesi a do not seem to have any deleterious effect on the disease. 4) Lastly MS d oes not seem to influence pregnancy, delivery or the child's health. The st udies available to date suffer from methodological limitations. They need t o be confirmed by prospective studies. This is the purpose of the study ent itled "Pregnancy in multiple sclerosis, PRIMS", which has been carried out since 1992 at the European level.