{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:23:54Z","timestamp":1787840634832,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Multiple sclerosis (MS) is a chronic disease of the central nervous system. Most women with MS are diagnosed during their reproductive ages. The aim of this study was to evaluate the interaction between fertility, pregnancy, and MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>\n                      A retrospective descriptive\u2013analytic study was conducted on 110 women suffering from MS with a history of pregnancy (between 2007 and 2017 years) in Isfahan, Iran. Samples were selected in a census model. Women completed a researcher-constructed questionnaire by telephone. The questionnaire consisted of three parts: demographic information, MS and its symptoms and treatment, and reproductive system and the history of pregnancy associated with MS. The data were analyzed by SPSS software version 16 using Chi-square, ANOVA, and\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The mean age of women was 32.4 years. In this population, the average number of pregnancies was 1.61, the number of deliveries was 1.35, the number of abortions was 0.24, the history of ectopic pregnancy was 0.01, the number of alive children was 1.36, and the number of dead children was 0.01. The average time of the last MS attack before the pregnancy was 21.36 months. Fatigue (24.5%) was the most common symptom exacerbated during pregnancy. MS symptoms improved in 55.0% of women in the second trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>MS had no effect on the pregnancy status, such as the number of abortions, ectopic pregnancy, alive and dead children, and the duration of pregnancy. Symptoms of the disease improved during pregnancy. Therefore, pregnancy has a protective role against MS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jehp.jehp_1107_20","type":"journal-article","created":{"date-parts":[[2024,4,23]],"date-time":"2024-04-23T12:47:54Z","timestamp":1713876474000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Investigating the interaction between fertility, pregnancy, and multiple sclerosis"],"prefix":"10.4103","volume":"10","author":[{"given":"Freshteh","family":"Ashtari","sequence":"first","affiliation":[{"name":"Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Mokhtari","sequence":"additional","affiliation":[{"name":"MSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahboubeh","family":"Valiani","sequence":"additional","affiliation":[{"name":"Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Soudavi","sequence":"additional","affiliation":[{"name":"Deputy of Treatment, Diseases Management Department, Isfahan University of Medical Sciences Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Homa","family":"Saadat","sequence":"additional","affiliation":[{"name":"Deputy of Treatment, Diseases Management Department, Isfahan University of Medical Sciences Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Tolouei","sequence":"additional","affiliation":[{"name":"Deputy of Treatment, Isfahan University of Medical Sciences Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Mansourian","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Biostatistics and Epidemiology, Health School, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,6]]},"reference":[{"key":"R1-20250921","doi-asserted-by":"crossref","first-page":"1502e17","DOI":"10.1016\/S0140-6736(08)61620-7","article-title":"Multiple sclerosis","volume":"372","author":"Compston","year":"2008","journal-title":"Lancet"},{"key":"R2-20250921","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/1471-2377-13-128","article-title":"Incidence and prevalence of multiple sclerosis in Europe: A systematic review","volume":"13","author":"Kingwell","year":"2013","journal-title":"BMC Neurol"},{"key":"R3-20250921","first-page":"134","article-title":"The diagnosis of multiple sclerosis and the various related demyelinating syndromes: A critical review","volume":"48-9","author":"Dimitrios","year":"2014","journal-title":"J Autoimmunity"},{"key":"R5-20250921","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1001\/jamaneurol.2013.55","article-title":"The gender gap in multiple sclerosis: Intersection of science and society","volume":"70","author":"Dunn","year":"2013","journal-title":"JAMA Neurol"},{"key":"R6-20250921","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1159\/000365846","article-title":"Estimated prevalence and incidence of multiple sclerosis in Iran","volume":"72","author":"Etemadifar","year":"2014","journal-title":"Eur Neurol"},{"key":"R7-20250921","first-page":"E22028","article-title":"A Review of geoepidemiological differences of multiple sclerosis in Iran and other Middle East countries","volume":"2","author":"Zahra","year":"2015","journal-title":"Arch Neurosci J"},{"key":"R8-20250921","first-page":"278","article-title":"Defining the clinical course of multiple sclerosis","volume":"83","author":"Lublin","year":"2014","journal-title":"J Neurol Am Academy Neurol"},{"key":"R10-20250921","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.annepidem.2014.04.007","article-title":"Does pregnancy alter the long-term course of multiple sclerosis?","volume":"24","author":"Karp","year":"2014","journal-title":"Ann Epidemiol"},{"key":"R11-20250921","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1002\/ana.22366","article-title":"Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria","volume":"69","author":"Polman","year":"2011","journal-title":"Ann Neurol"},{"key":"R12-20250921","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ijgo.2016.01.008","article-title":"The effect of postpartum intravenous immunoglobulins on the relapse rate among patients with multiple sclerosis","volume":"134","author":"Brandt-Wouters","year":"2016","journal-title":"Int J Gynecol Obstetrics"},{"key":"R13-20250921","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1212\/WNL.0b013e31824c4648","article-title":"Offspring number, pregnancy, and risk of a first clinical demyelinating event: The AusImmune Study","volume":"78","author":"Ponsonby","year":"2012","journal-title":"Neurology"},{"key":"R14-20250921","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.jri.2012.10.005","article-title":"Gold Pregnancy and multiple sclerosis: feto-maternal immune cross talk and its implications for disease activity","volume":"97","author":"Patas","year":"2013","journal-title":"J Reproduct Immunol"},{"key":"R15-20250921","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1056\/NEJM199807303390501","article-title":"Rate of pregnancy-related relapse in multiple sclerosis","volume":"339","author":"Confavreux","year":"1998","journal-title":"N Engl J Med"},{"key":"R16-20250921","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1038\/nature10251","volume":"476","year":"2011","journal-title":"Nature"},{"key":"R17-20250921","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1038\/ng.2770","article-title":"Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis","volume":"45","author":"Beecham","year":"2013","journal-title":"Nat Genet"},{"key":"R18-20250921","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/2277-9531.171796","article-title":"The challenges of healthcare delivery to people with multiple sclerosis in Iran","volume":"4","author":"Yazdannik","year":"2015","journal-title":"J Educ Health Promot"},{"key":"R19-20250921","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jns.2010.12.008","article-title":"Sleep disorders and fatigue in multiple sclerosis: Evidence for association and interaction","volume":"302","author":"Kaminska","year":"2011","journal-title":"J Neurol Sci"},{"key":"R20-20250921","doi-asserted-by":"crossref","first-page":"106","DOI":"10.4103\/jehp.jehp_185_17","article-title":"Relation between personality disorders and characteristics of multiple sclerosis patients and their parents","volume":"7","author":"Kamal","year":"2018","journal-title":"J Edu Health Promot"},{"key":"R21-20250921","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1007\/s10072-017-2999-1","article-title":"Definitive childlessness in women with multiple sclerosis: A multicenter study","volume":"38","author":"Ferraro","year":"2017","journal-title":"Neurol Sci"},{"key":"R22-20250921","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1007\/s00415-015-7663-1","article-title":"Fecundity in women with multiple sclerosis: An observational mono-centric study","volume":"262","author":"Roux","year":"2015","journal-title":"J Neurol"},{"key":"R23-20250921","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1878-5085-3-9","article-title":"Expert recommendations to personalization of medical approaches in treatment of multiple sclerosis: An overview of family planning and pregnancy","volume":"3","author":"Borisow","year":"2012","journal-title":"EPMA J"},{"key":"R24-20250921","doi-asserted-by":"crossref","first-page":"399","DOI":"10.2217\/WHE.12.33","article-title":"Multiple sclerosis and pregnancy: Maternal considerations","volume":"8","author":"Alwan","year":"2012","journal-title":"Women's Health"},{"key":"R25-20250921","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/1352458514549406","article-title":"Female infertility and multiple sclerosis: Is this an issue?","volume":"21","author":"McCombe","year":"2015","journal-title":"Mult Scler J"},{"key":"R27-20250921","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1177\/1352458513498126","article-title":"Reverse causality behind the association between reproductive history and MS","volume":"20","author":"Hedstr\u00f6m","year":"2014","journal-title":"Mult Scler"},{"key":"R28-20250921","first-page":"213","article-title":"Assessment of ovarian reserve and Doppler characteristics in patients with multiple sclerosis using immunomodulating drugs","volume":"10","author":"Cil","year":"2009","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"R29-20250921","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1177\/1352458515602339","article-title":"Pituitary-ovary axis and ovarian reserve in fertile women with multiple sclerosis: A pilot study","volume":"22","author":"Sep\u00falveda","year":"2016","journal-title":"Mult Scler"},{"key":"R30-20250921","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.clim.2013.02.001","article-title":"Artificial reproductive techniques in multiple sclerosis","volume":"149","author":"Hellwig","year":"2013","journal-title":"Clin Immunol"},{"key":"R31-20250921","doi-asserted-by":"crossref","first-page":"216","DOI":"10.3109\/09513590.2010.487595","article-title":"The effect of different hormone therapies on anti-m\u00fcllerian hormone serum levels in anovulatory women of reproductive age","volume":"27","author":"F\u00e1bregues","year":"2011","journal-title":"Gynecol Endocrinol"},{"key":"R32-20250921","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/S0002-9378(16)39356-5","article-title":"Pregnancy and multiple sclerosis","volume":"55","author":"Douglass","year":"1948","journal-title":"Am J Obstet Gynecol"}],"container-title":["Journal of Education and Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_1107_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:26:15Z","timestamp":1787837175000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_1107_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/jehp.jehp_1107_20","relation":{},"ISSN":["2277-9531","2319-6440"],"issn-type":[{"value":"2277-9531","type":"print"},{"value":"2319-6440","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]},"assertion":[{"value":"2020-09-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}