Abstract Details

Title Brain MRI Activity During the Year Before Pregnancy Can Predict Long-Term Clinical Worsening in Patients with Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-018

Objective

The aim of the study was to evaluate the correlation between Magnetic Resonance Imaging (MRI) activity in the year before pregnancy and the long-term clinical meaningful worsening in Expanded Disability Status Scale (EDSS).

Background

While fewer Multiple Sclerosis (MS) relapses occur during pregnancy, relapse risk increases in the early post-partum period. We showed in a previous study a correlation between an active-MRI pre-conception and the early post-partum disease activity as evidenced by MRI activity and relapses. Increased post-partum disease activity may predict a poor long-term prognosis.

Design/Methods An observational retrospective case–control study included 141 pregnancies in 99 females with MS. Statistical analyses were used to evaluate the correlation between MRI-activity in the year pre-pregnancy and post-partum clinical worsening during 5-years follow-up. Clustered logistic regression was used to investigate the predictors of 5-years clinical meaningful worsening in EDSS (lt-EDSS).

Results We found a significant correlation for an active-MRI pre-pregnancy and lt-EDSS (p=0.0006). EDSS pre-pregnancy and lt-EDSS also significantly correlated (p=0.043). Using a multivariate model, we predicted which females won’t experience long-term clinical deterioration by a stable-MRI pre-pregnancy (89.6% specificity; p=0.012).

Conclusions An active-MRI pre-conception is a strong predictor of lt-EDSS and higher annual relapse-rate (ARR) during the follow-up period, regardless of whether the female had clinical evidence of disease activity prior to conception and delivery. Optimizing disease control and achieving both clinical and imaging stability pre-conception and post-delivery may reduce the risk of long-term clinical deterioration.

Authors/Disclosures
Omri Zveik, MD PRESENTER	Mr. Zveik has nothing to disclose.
	No disclosure on file
Netta Levin, MD, PhD (Hadassah Hebrew University Hospital)	Dr. Levin has nothing to disclose.
Ariel Rechtman (Hadassah-Hebrew University Medical Center)	Ariel Rechtman has nothing to disclose.
	No disclosure on file
Adi Vaknin-Dembinsky, MD	Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medison Pharma. Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for neopharm group. Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for medisone . Dr. Vaknin-Dembinsky has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for alexion.

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