Live Birth Rates Among Women With Multiple Sclerosis in Sweden, 2004 to 2022: A Population-Based Registry Study
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Background
Women with multiple sclerosis (MS) have fewer children than other women, but whether this narrowed as pregnancy evidence became reassuring and treatment options expanded is uncertain.
Objective
To compare live birth trends from 2004 to 2022 between women with MS and all Swedish women.
Methods
Linking the Swedish MS, National Patient, and Medical Birth Registers with national statistics, we compared age-standardised live birth rates, counted expected births at national rates, and estimated adjusted annual live-birth risk ratios in a matched comparison sample.
Results
Women with MS (n=10,452; 76,989 woman-years) had 3,577 children, about 1,200 (25%) fewer than expected (observed-to-expected ratio 0.75, 95% CI 0.72 to 0.77). Standardised rate ratios were below 1 annually (median 0.77). Observed-to-expected ratios were 0.73 (0.68 to 0.79) in 2004 to 2008 and 0.70 (0.65 to 0.75) in 2019 to 2022 (population-by-period interaction p=0.31). Age- and region-adjusted risk ratios ranged from 0.75 to 0.86 across periods (heterogeneity p=0.020), closest to 1 in 2009 to 2013.
Conclusion
Women with MS had about one quarter fewer live births than other Swedish women, and the difference was similar in the first and last periods.
