Cesarean sections prior to 39 weeks among pregnant patients with multiple sclerosis.

Authors

Mandisa L Keswa, Sana R Desai, Francesca K Dzukou, Jessica B Smith, Irogue I Igbinosa, Annette M Langer-Gould

Published in

Multiple sclerosis (Houndmills, Basingstoke, England). Pages 13524585261481729. Sep 03, 2026. Epub Sep 03, 2026.

Abstract

Pregnant women with multiple sclerosis have higher Cesarean section (C-section) rates than controls. Whether these are occurring prior to 39 weeks' gestation is unclear and important, as C-sections <39 weeks are associated with increased neonatal morbidity and are not recommended unless medically indicated.
Determine whether pregnant women with multiple sclerosis experience higher rates of non-medically indicated C-sections <39 weeks and whether these were attributed to multiple sclerosis.
We conducted a retrospective, population-based case-control study of pregnancies ⩾20 weeks' gestation among pregnant women with multiple sclerosis and 2:1 matched controls (1 January 2009-30 June 2024). Electronic health records identified C-sections <39 weeks and were manually reviewed for outcomes and covariates.
Among 600 MS pregnancies and 1199 controls, C-sections <39 weeks were more frequent in pregnant women with multiple sclerosis (15.2% vs 9.8%, p = 0.0007). However, non-medically indicated C-sections <39 weeks were uncommon and did not differ significantly between groups (pregnant women with multiple sclerosis 3.7% vs controls 2.8%, p = 0.3386). The higher proportion of medically indicated C-sections <39 weeks in pregnant women with multiple sclerosis (11.5% vs 6.9%, p = 0.001) was driven by high-risk myomectomy and stalled labor. Multiple sclerosis was documented as a pregnancy complication in 24.2% of cases.
C-sections <39 weeks were more common in pregnant women with multiple sclerosis but were attributable to standard obstetric indications rather than multiple sclerosis. Documentation of multiple sclerosis as a pregnancy complication suggests persistent provider misconceptions.

PMID:
42693763
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

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