Menarche, pregnancies, and breastfeeding do not modify long-term prognosis in multiple sclerosis
Zuluaga Rodas, María Isabel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Otero-Romero, Susana (Hospital Universitari Vall d'Hebron)
Rovira, Alex (Hospital Universitari Vall d'Hebron)
Pérez-Hoyos, Santiago (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Arrambide, Georgina (Hospital Universitari Vall d'Hebron)
Negrotto, L. (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Galan, Ingrid (Hospital Universitari Vall d'Hebron)
Río, Jordi (Hospital Universitari Vall d'Hebron)
Comabella, Manuel (Hospital Universitari Vall d'Hebron)
Nos, Carlos. (Hospital Universitari Vall d'Hebron)
Arévalo, María Jesús (Hospital Universitari Vall d'Hebron)
Vidal-Jordana, Angela (Hospital Universitari Vall d'Hebron)
Castilló, Joaquín (Hospital Universitari Vall d'Hebron)
Rodríguez Acevedo, Breogán (Hospital Universitari Vall d'Hebron)
Midaglia, Luciana (Hospital Universitari Vall d'Hebron)
Mulero, P. (Hospital Universitari Vall d'Hebron)
Mitjana, Raquel (Hospital Universitari Vall d'Hebron)
Auger, Cristina (Hospital Universitari Vall d'Hebron)
Sastre-Garriga, Jaume (Hospital Universitari Vall d'Hebron)
Montalban, Xavier (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Tintoré, Mar (Division of Neurology. St. Michael's Hospital. University of Toronto)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	ObjectiveTo investigate the effect of menarche, pregnancies, and breastfeeding on the risk of developing multiple sclerosis (MS) and disability accrual using a multivariate approach based on a large prospective cohort of patients with clinically isolated syndrome (CIS). MethodsA cross-sectional survey of the reproductive information of female participants in a CIS cohort was performed. We examined the relationship of age at menarche with the risk of clinically definite MS (CDMS), McDonald 2010 MS, and Expanded Disability Status Scale (EDSS) 3. 0 and 6. 0. The effect of pregnancy (before and after CIS) and breastfeeding in the risk of CDMS, McDonald 2010 MS, and EDSS 3. 0 was also examined. Univariate and multivariate analyses were performed and findings were confirmed using sensitivity analyses and a propensity score model. ResultsThe data of 501 female participants were collected. Age at menarche did not correlate with age at CIS and was not associated with the risk of CDMS or EDSS 3. 0 or 6. 0. Pregnancy before CIS was protective for CDMS in the univariate analysis, but the effect was lost in the multivariate model and did not modify the risk of EDSS 3. 0. Pregnancy after CIS was protective for both outcomes in univariate and multivariate analyses when pregnancy was considered a baseline variable, but the protective effect disappeared when analyzed as a time-dependent event. Breastfeeding did not modify the risk for the 3 outcomes. ConclusionsThese results demonstrate that menarche, pregnancies, and breastfeeding did not substantially modify the risk of CDMS or disability accrual using a multivariable and time-dependent approach.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Adult ; Age Factors ; Breast Feeding ; Cohort Studies ; Cross-Sectional Studies ; Demyelinating Diseases ; Disease Progression ; Female ; Gravidity ; Humans ; Menarche ; Multiple Sclerosis ; Pregnancy ; Prognosis ; Prospective Studies ; Reproductive History ; Young Adult
Publicado en:	Neurology, Vol. 92 Núm. 13 (26 2019) , p. E1507-E1516, ISSN 1526-632X

DOI: 10.1212/WNL.0000000000007178
PMID: 30824557

10 p, 331.3 KB

El registro aparece en las colecciones:
Artículos > Artículos de investigación
Artículos > Artículos publicados