Studies

Childbirth May Slow Progression of Multiple Sclerosis

TUESDAY, Nov. 24 (HealthDay News) -- Having children may slow the progression of multiple sclerosis, new research suggests.

Belgian researchers followed 330 women who had experienced their first MS symptoms between the ages of 22 and 38.

Women who had given birth to at least one child were 34 percent less likely to have the disease progress to a stage in which they needed walking assistance, such as a cane or brace, than women without children.

While having a baby either before or after the onset of MS symptoms seemed to help, women who had a child after they began experiencing MS symptoms were even better off. During the study, women with MS symptoms who'd had a baby were 39 percent less likely to have their disease progress to the point of needing walking assistance. In the study, women had the disease for an average of 18 years.

"Women with MS who have children seem to have a more benign MS course than those who don't," said study author Marie D'hooghe, of the department of neurology at Nationaal MS Centrum in Melsbroek, Belgium.

The research appears in the Nov. 24 online issue of the Journal of Neurology, Neurosurgery & Psychiatry.

Multiple sclerosis is an autoimmune disease in which the body's own defense system attacks myelin, or the protective fatty substance that surrounds nerve fibers in the central nervous system, according to the National Multiple Sclerosis Society. The damage causes a disruption to nerve signals traveling to and from the brain, which causes the numbness, walking problems, blurry vision and fatigue.

About 85 percent of those with MS start with a relapsing-remitting course, in which attacks are followed by partial or total recovery, according to the study. More than half go on to develop a more progressive form of the disease, in which symptoms worsen over time and there are fewer, shorter periods without symptoms. Eventually, the disease can lead to loss of vision and paralysis.

Women are twice as likely to develop MS as men, though women tend to have less severe cases than men, according to the study.

About three-quarters of the women in the study had children. The researchers measured the time it took for women to reach level 6 on the Expanded Disability Status Scale (EDSS), a rating system used by doctors to describe symptoms, with level 1 being the least severe and 10 being death due to MS. Level 6 is defined as needing a cane, crutch or brace to walk.

Women who did not have children took an average of 13 to 15 years to progress to EDSS 6, while women who had children took an average of 22 to 23 years to reach that stage, the researchers found.

"Having one or more children does seem to be beneficial," said Patricia O'Looney, director of biomedical research for the National Multiple Sclerosis Society. "But we don't know enough about the patient demographics to really draw some major conclusions."

Among the unknowns are the treatments the women in the study were getting for MS or if perhaps the women who decided to have children were feeling better and having fewer symptoms.

Though much remains to be learned about the role of pregnancy in MS, a possible reason why it may help slow the progression of the disease is that during pregnancy, the immune system is "downregulated," in part to prevent the mother's body from rejecting the fetus, O'Looney explained. Suppressing the immune system may also help to control MS, O'Looney noted.

Treatments for MS, such as interferon beta-1a and -1b, work by suppressing the immune system.

A second possibility for why childbirth might help delay the progression of MS is that during pregnancy, estrogen levels rise. Previous research has suggested estrogen may help protect from MS by stimulating the cells that make myelin. The MS Society is currently funding a clinical trial in which women with MS are given estriol, a form of estrogen, along with standard MS treatments.

"The sex hormones do seem to have some neuroprotective role, though we are not quite sure how," O'Looney said.

Still, O'Looney stressed that women should not interpret the results as reason to have a baby to delay the progression of the disease, or blame themselves if they decided not to have children.

"We still don't know a lot about the great variability of MS -- why does one person become more progressive while another follows a more benign course," O'Looney said. "What's certain is that one should not conclude it's based on whether or not you have a child. There are so many other factors, including possibly genetic factors, that determine that."

More information

The National Multiple Sclerosis Society has more on pregnancy and MS.

SOURCES: Marie D'hooghe, department of neurology, Nationaal MS Centrum in Melsbroek, Belgium; Patricia O'Looney, Ph.D., director, biomedical research, National Multiple Sclerosis Society; Nov. 24, 2009, Journal of Neurology, Neurosurgery & Psychiatry, online

Childhood Brain Cancer Causes Other Long-Term Problems

MONDAY, Nov. 2 (HealthDay News) -- Childhood brain cancer survivors have ongoing cognitive problems and achieve lower levels of education, employment and income than their siblings and survivors of other types of cancer, a U.S. study has found.

The findings, published by the American Psychological Association in the November issue of Neuropsychology, highlight the importance of programs to support childhood brain cancer survivors' transition to adulthood, said Leah Ellenberg, a clinical faculty member of the David Geffen School of Medicine at the University of California, Los Angeles.

Ellenberg and colleagues analyzed responses to a questionnaire filled out by 785 childhood brain cancer survivors 16 years after their diagnosis. The same questionnaire was completed by 5,870 survivors of cancers such as leukemia, Hodgkin's disease and bone tumors, and 379 siblings of childhood brain cancer survivors.

The study found that childhood brain cancer survivors reported significantly greater neurocognitive dysfunction than their siblings or other cancer survivors. All areas of cognitive function were affected in childhood brain cancer survivors, including organization and emotional regulation.

The most commonly reported problems were in memory and efficiency, such as forgetting what they're doing in the middle of a task and being slower than others at completing work. More than half of childhood brain cancer survivors reported significant difficulty with at least one task efficiency item, a rate three times higher than among their siblings.

The most serious neurocognitive problems were reported by childhood brain cancer survivors with significant motor or sensory problems after treatment, those who were treated with radiation to their brains, and those who had tumors in the brain cortex rather than in lower brain regions, the researchers found.

The neurocognitive issues reported by childhood brain cancer survivors were associated with significantly poorer adaptation to adult life, including lower achievement in education, full-time employment and income. They were also less likely to be married, the study authors noted.

The study "underscores the need for continued attention to mitigating the long-term negative effects of [childhood brain cancers] and their treatment," the study authors wrote. They added that it's "important to investigate the benefits of early and consistent use of compensatory strategies, including assistive technology, transitional facilities to promote independent living, and job placement and coaching, to enhance functional outcomes."

More information

The Nemours Foundation has more about childhood brain tumors.

SOURCE: American Psychological Association, news release, Nov. 2, 2009