Pregnancy and Fetal Outcomes in Omani Women with Multiple Sclerosis, Single Tertiary Center Experience

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) which affects women more than men. MS is more prevalent among the young, which has an implication for MS women during their childbearing age. The fertility rate of women with MS is reported to be lower than normal women. It is known from previous studies that pregnant MS patients have more obstetric complications compared to non-MS patients. Some studies suggested that newborns of MS mothers are more likely to be delivered with poor fetal growth. There are limited options of disease-modifying therapies (DMTs) to be used during pregnancy and only if the benefits outweigh the risks. There is a paucity of literature in this area in the region. This study aims to evaluate the fertility rate, obstetric complications, and fetal outcomes in Omani women with MS who attended the neurology clinic at Sultan Qaboos University Hospital (SQUH). This retrospective study included Omani MS patients who attended the neurology clinic at SQUH from the 1st of January 2007 till the 30th of June 2021. Demographic and clinical data were extracted from the patient electronic medical records (EPR) of the hospital information system (HIS). Obstetric data and fetal outcomes were collected from the green and pink cards, respectively. The Medical Research Ethic Committee of COMHS approved the research proposal. We collected the data of 25 Omani women with MS who had 52 pregnancies. The 52 pregnancies resulted in 34 healthy deliveries, 13 abortions, and five ongoing pregnancies at the time of data collection. The 25 women had a fertility rate of about 2.6 children per woman, below the national figures of 3.6. Fifty-nine percent of the pregnant women did not have any obstetric complications during conception. Caesarian section and gestational diabetes were more common in MS mothers compared to the national figures. The mean birth weight and birth length of the offspring of MS mothers were 2.93 kgs and 49.71 cm, respectively, below the national statistics. However, the mean head circumference was 33.88 cm, similar to the national figure. Omani MS patients have a lower fertility rate compared to the national figures. Omani MS patients have a higher incidence of obstetric complications. The weight and length of MS patients’ newborns were below average.