{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T04:13:48Z","timestamp":1793160828338,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1156519"],"award-info":[{"award-number":["GNT1156519"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pregnancy does not adversely affect disability outcomes in women with multiple sclerosis (MS). However, it remains uncertain whether pregnancy is associated with slower disability accumulation, and whether this association differs according to the timing of pregnancy during the disease course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This observational cohort study used prospectively ascertained data in the international MSBase Registry (1991\u20132022), supplemented with retrospective surveys detailing participants\u2019 complete pregnancy histories. The study included women with mild relapse-onset MS, defined as an Expanded Disability Status Scale (EDSS) score of 2.5 or below. A flexible parametric survival model was used to assess the time-varying effect of live-birth pregnancy on reaching sustained EDSS 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We included 2079 women, of whom 571 had a live-birth pregnancy after baseline. Live-birth pregnancies occurring within the first 4.42\u2009years of follow-up were associated with longer time to sustained EDSS 3. At 10\u2009years, live birth was associated with an absolute cumulative difference of 0.51\u2009years in time to this disability milestone (95% confidence interval (CI): 0.23, 0.79). Among women with live births, postpartum relapses were associated with shorter time to sustained EDSS 3 (hazard ratio (HR): 1.61; 95% CI: 1.02, 2.55).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Live-birth pregnancy occurring earlier in follow-up was associated with a longer time to disability accrual.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261464055","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T13:13:15Z","timestamp":1785330795000},"page":"1323-1333","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between pregnancy timing and disability outcomes in women with mild relapse-onset multiple sclerosis"],"prefix":"10.1177","volume":"32","author":[{"given":"Jessica","family":"Shipley","sequence":"first","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G","family":"Sanfilippo","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Skibina","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alfred Health, Melbourne, VIC, Australia; Department of Neurology, Box Hill Hospital, Box Hill, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3778-1376","authenticated-orcid":false,"given":"Tomas","family":"Kalincik","sequence":"additional","affiliation":[{"name":"CORe, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia; Neuroimmunology Centre, Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raed","family":"Alroughani","sequence":"additional","affiliation":[{"name":"Department of Neurology, Al-Amiri Hospital, Kuwait City, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce V","family":"Taylor","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis \u2013 Menzies Institute for Medical Research, University of Tasmania, Dynnyrne, TAS, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Macdonell","sequence":"additional","affiliation":[{"name":"Department of Neurology, Austin Health, Heidelberg, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3785-4742","authenticated-orcid":false,"given":"Vicki E","family":"Maltby","sequence":"additional","affiliation":[{"name":"Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia; Hunter Medical Research Institute, School of Medicine and Public Health, The University of Newcastle, New Lambton Heights, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Lechner-Scott","sequence":"additional","affiliation":[{"name":"Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia; Hunter Medical Research Institute, School of Medicine and Public Health, The University of Newcastle, New Lambton Heights, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi N","family":"Beadnall","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Clinic, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4278-7003","authenticated-orcid":false,"given":"Anneke","family":"van der Walt","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3940-8727","authenticated-orcid":false,"given":"Helmut","family":"Butzkueven","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3942-4340","authenticated-orcid":false,"given":"Vilija G","family":"Jokubaitis","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Health, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012084"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2023-331525"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00426-4"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200328"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458507086103"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2023.103388"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199807303390501"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006382"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513507816"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756285608100416"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458518816614"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102241"},{"issue":"2","key":"e_1_3_5_14_2","article-title":"Relapse recovery in multiple sclerosis: Effect of treatment and contribution to long-term disability","volume":"7","author":"Sotiropoulos MG","year":"2021","unstructured":"Sotiropoulos MG, Lokhande H, Healy BC, et al. 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