Pregnancy is a major modifier of disease activity in MS, with studies showing that relapse rates fall by as much as 70% during the third trimester compared with the number of relapses previous to pregnancy [Saraste et al, 2007]. After delivery, however, the disease is reactivated, and during the first four months post-partum the relapse frequency is higher than it was pre-pregnancy. The relapse rate then usually returns back to the pre-pregnancy rate within 12 months [Ghezzi et al, 2013]. To mitigate these post-partum relapses, DMTs may be restarted soon after birth.
Studies have also shown that there were no significant differences in the rates of relapse between women who underwent epidural analgesia and those who did not; and that women who breast-fed had a significantly lower rates of relapse than those who chose to bottle-feed [Confavreux et al, 1998].