{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:33:31Z","timestamp":1777937611239,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pregnancies have an impact on the disease course of multiple sclerosis (MS), but their relationship with MS risk is yet unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine the relationships of pregnancies and gynecological diagnoses with MS risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this retrospective case\u2013control study, we assessed differences in gynecological International Classification of Diseases, 10th Revision (ICD-10) code recording rates between women with MS ( n\u2009=\u20095720), Crohn\u2019s disease ( n\u2009=\u20096280), or psoriasis ( n\u2009=\u200940,555) and women without these autoimmune diseases ( n\u2009=\u200926,729) in the 5 years before diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-eight ICD-10 codes were recorded less frequently for women with MS as compared to women without autoimmune disease, 18 of which are pregnancy-related. After adjustment for pregnancies, all codes unrelated to pregnancies were still negatively associated with MS. In a sensitivity analysis excluding women with evidence for possible demyelinating events before diagnosis, all associations were more pronounced. In comparison to women with psoriasis, most associations could be confirmed; that was not true in comparison to women with Crohn\u2019s disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our findings provide evidence for a possible protective effect of pregnancies on MS risk likely independent of or in addition to a previously suggested reversed causality. The negative associations of gynecological disorders with disease risk need further investigation. The associations might be shared by different autoimmune diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585221080542","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T06:47:20Z","timestamp":1647586040000},"page":"1630-1640","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Association of pregnancies with risk of multiple sclerosis"],"prefix":"10.1177","volume":"28","author":[{"given":"Christiane","family":"Gasperi","sequence":"first","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Hapfelmeier","sequence":"additional","affiliation":[{"name":"Institute for AI and Informatics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany\/Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonius","family":"Schneider","sequence":"additional","affiliation":[{"name":"Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus A","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Institute for AI and Informatics in Medicine, TUM School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0668-0049","authenticated-orcid":false,"given":"Ewan","family":"Donnachie","sequence":"additional","affiliation":[{"name":"Bavarian Association of Statutory Health Insurance Physicians, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5985-6784","authenticated-orcid":false,"given":"Bernhard","family":"Hemmer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, TUM School of Medicine, Technical University of Munich, Munich, Germany\/ Munich Cluster for Systems Neurology (SyNergy), Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,3,18]]},"reference":[{"key":"bibr1-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511403794"},{"key":"bibr2-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08220-X"},{"key":"bibr3-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.162784"},{"key":"bibr4-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws099"},{"key":"bibr5-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1177\/1756285613488434"},{"key":"bibr6-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199807303390501"},{"key":"bibr7-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006382"},{"key":"bibr8-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513481397"},{"key":"bibr9-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31824c4648"},{"key":"bibr10-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513498126"},{"key":"bibr11-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e31821c7adc"},{"key":"bibr12-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1396815"},{"key":"bibr13-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012074"},{"key":"bibr14-13524585221080542","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2018.00057"},{"key":"bibr15-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/80.1.27"},{"key":"bibr16-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"},{"key":"bibr17-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25247"},{"key":"bibr18-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1177\/1352458518783662"},{"key":"bibr19-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1080\/14737175.2020.1746645"},{"key":"bibr20-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.01.019"},{"key":"bibr21-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.3324"},{"key":"bibr22-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1177\/2516865719867090"},{"key":"bibr23-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149094"},{"key":"bibr24-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.6.848"},{"key":"bibr25-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.62.9.1362"},{"key":"bibr26-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.141.5.601"},{"key":"bibr27-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1996.tb01632.x"},{"key":"bibr28-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1136\/gut.21.6.469"},{"key":"bibr29-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1007\/BF02051924"},{"key":"bibr30-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgen.1002254"},{"key":"bibr31-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3528"},{"key":"bibr32-13524585221080542","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00871"},{"key":"bibr33-13524585221080542","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143722"},{"key":"bibr34-13524585221080542","unstructured":"eurostat Data Browser, https:\/\/ec.europa.eu\/eurostat\/databrowser\/view\/tps00017\/default\/table?lang=eng (accessed 7 May 2021)."},{"key":"bibr35-13524585221080542","unstructured":"The World Bank, https:\/\/data.worldbank.org\/indicator\/SP.DYN.CBRT.IN?locations=US-DE-GB (accessed 4 May 2021)."}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585221080542","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585221080542","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585221080542","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:09:05Z","timestamp":1777694945000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585221080542"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,18]]},"references-count":35,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1177\/13524585221080542"],"URL":"https:\/\/doi.org\/10.1177\/13524585221080542","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,18]]}}}