Multiple sclerosis (MS) affects women three times more commonly than men, and the clinical onset is often during childbearing years. Although healthcare claims data are collected for administrative rather than research purposes, they can provide insight into outcomes of women with MS and pregnancy in a real-world population. This study aimed to evaluate pregnancy outcomes of women with MS in a large US claims database.
This was a retrospective analysis of women aged 18-65 years with MS (International Classification of Diseases, Ninth Revision, Clinical Modification code: 340.xx), a pregnancy-related claim (diagnosis code or procedure), and 1 year continuous eligibility pre- and post-pregnancy claim from the IMS Health Real World Data Adjudicated Claims – US database (from 1/1/2006-30/6/2015). Pregnancy outcomes evaluated were: indication of a live birth; complications during pregnancy, labour and delivery, and the puerperium period; ectopic and molar pregnancies; and other abortive outcomes.
A total of 205,466 women with MS were included; 10,630 had a pregnancy claim. Of those, 5022 had 1 year of continuous eligibility pre- and post- pregnancy claim. The mean (standard deviation [SD]) age of women with a pregnancy claim who met the eligibility criteria was 34.3 (8.1) years. Most patients had commercial health insurance (98.1%) and were from the Northeast (32.2%), Midwest (29.9%), or South regions (29.2%) of the US. The mean (SD) Charlson Comorbidity Index score was 0.35 (0.89) pre- and 0.34 (0.87) post-pregnancy claim. Common comorbidities included gastrointestinal disorders (17.6%), depression (14.4%), thyroid disease (14.1%), hypertension (13.5%), anxiety (12.3%), and hyperlipidaemia (10.5%). Over half had a live birth (n=2867; 57.1%). The proportions of women with claims for complications during pregnancy were: diabetes/abnormal glucose test, 12.0%; infection, 8.5%; mental health disorders, 5.0%; hyperemesis gravidarum/vomiting, 5.2%; thyroid disease, 4.2%; pre-eclampsia/eclampsia, 4.2%; and placental problems, 4.0%. The proportions of women with claims during labour and delivery were: malposition/disproportion, 31.9%; forceps/C-section, 8.5%; and haemorrhage, 8.0%. The proportion of women with claims for ectopic and molar pregnancy was 13.0% and for other pregnancy with abortive outcomes was 14.7%.
This study presents pregnancy outcomes of women with MS from a large US administrative claims database.