Researchers examined medical records of women with MS in the U.S. and their pregnancy outcomes, comparing those of Black, Hispanic/Latinx, and white people. They reported that those identifying as Black or Hispanic/Latinx tended to enter pregnancy with higher levels of MS disability and often with fewer health care resources. There were also differences in types of delivery, birthweights, and socioeconomic factors.
Why Does This Matter? This study adds to the growing awareness of health disparities and can inform ongoing efforts to improve care for everyone living with MS.
Background: MS is highly individualized, and disease characteristics and a treatment plan are significant considerations in family planning and pregnancies. These investigators wanted to understand how healthcare inequities may impact the pregnancy outcomes of Black and Hispanic/Latinex women. Previous studies suggest that prenatal care is especially important for Black and Hispanic/Latinx women because they tend to have higher risks of high blood pressure, diabetes and other disorders that may complicate their pregnancies.
Study Details: To better understand differences among women with MS and their pregnancy experiences, Dr. Riley Bove (University of California, San Francisco - UCSF), a National MS Society Harry Weaver Scholar, and collaborators examined medical records from 9 MS centers in the U.S. They looked for pregnancy and delivery information of women with MS or
CIS (a single neurological event that indicates early MS) between 2010 and 2021. They analyzed 294 pregnancies that resulted in live births.
Results: Some differences they found included:
- Black and Hispanic/Latinx women tended to be younger than white women when they became pregnant, and they had higher levels of MS disability when they became pregnant.
- More white women had private insurance, and more received an ultrasound exam at 14 weeks of pregnancy.
- Black women had the highest rates of emergency cesarean deliveries, and Hispanic/Latinx women had the fewest delivery complications. Babies’ birthweights of both tended to be lower than those of white women.
Comment: The authors suggest that some reasons for the differences may include availability of transportation, types of insurance, social support, and access to prenatal care. Studies like these can inform ongoing efforts to improve care for everyone living with MS.
Anyone can read the published paper without need of a subscription:
“
Disparities by Race in Pregnancy Care and Clinical Outcomes in Women With Multiple Sclerosis,” by Anne Marie Radzik, BS, Lilyana Amezcua, MD, Annika Anderson, BA, Serena Gilmore, BS, Sophie Ahmad, MS, Rachel Brandstadter, MD, Michelle T. Fabian, MD, Edith L. Graham, MD, Sophia Hodgkinson, Lindsay Horton, MD, Dina A. Jacobs, MD, Ilana B. Katz Sand, MD, Amit Kohli, MD, Libby Levine, MS, AGNP-BC, Monica McLemore, PhD, Annette F. Okai, MD, Jasmin Patel, MD, Shane Poole, BS, Claire Riley, MD, Sammita Satyanarayan, MD, Lauren Tardo, MD, Elizabeth Verter, MD, Veronica Villacorta, BA, Vanessa Zimmerman, MSN, Leah Zuroff, MD, Mitzi J. Williams, MD, Maria K. Houtchens, MD, and Riley Bove, MD, MMSc, was published early online in
Neurology on January 23, 2024.