https://doi.org/10.1177/1352458520904545 https://doi.org/10.1177/1352458520904545 MULTIPLE SCLEROSIS MSJ JOURNAL journals.sagepub.com/home/msj 1 Multiple Sclerosis Journal 1–11 DOI: 10.1177/ 1352458520904545 © The Author(s), 2020. Article reuse guidelines: sagepub.com/journals- permissions Introduction Multiple sclerosis (MS) is an immune-mediated, inflammatory neurodegenerative disease of the cen- tral nervous system (CNS) often diagnosed in young adults. 1 The prevalence in the United States is increas- ing with 3:1 female-to-male predominance. 2 Clinical onset often occurs in early adulthood, at reproductive peak. 3 It is important to understand and optimize reproductive outcomes in this population. An estimated 20%–33% of MS patients give birth after disease onset. 4 There has been an increase in MS pregnancy rates from 2006 to 2014, despite corresponding decrease in healthy controls. 5 MS relapse rate generally declines in pregnancy. 5,6 Most studies suggest a subsequent increase in disease activity in early postpartum period. 5–8 However, one recent study reported postpartum disease stability, showing no increased risk postpartum. 9 Some popu- lation studies have shown no significant adverse effects of pregnancy on long-term disease progres- sion or disability. 10–12 Despite growing literature on maternal outcomes in MS, there is still paucity of data regarding perinatal and long-term pediatric outcomes in infants born to mothers with multiple sclerosis (IMS). Prospective growth and developmental outcomes in infants born to mothers with multiple sclerosis Tatenda Dawn Mahlanza, Maria Claudia Manieri, Eric C Klawiter, Andrew J Solomon, Ellen Lathi, Carolina Ionete, Idanis Berriosmorales, Christopher Severson, James Stankiewicz , Ann Cabot, Michael Elkort, Tanuja Chitnis , Riley Bove , Joshua Katz and Maria Houtchens Abstract Background: The importance of supporting pregnancy-related decisions in multiple sclerosis (MS) patients has increasingly been recognized and hence the need for prospective data on pregnancy and pedi- atric outcomes in this patient population. Objective: To assess prospective growth and developmental outcomes of infants born to mothers with multiple sclerosis (IMS). Methods: PREG-MS is a prospective multicenter cohort study in New England, United States. We fol- lowed 65 women with MS and their infants with up to 12 months consistent pediatric follow-up. Pediatric, neurologic, and demographic information was obtained via structured telephone interviews and validated with medical records. Results: No differences in infant weights and lengths with World Health Organization (WHO) 50th per- centile standards were observed (p > 0.05). However, larger head circumference (HC) measurements than WHO standards were reported in cohort infants (p < 0.05). There was no association between HC and markers of maternal MS activity, demographic, or social factors. No irreversible pediatric developmental abnormalities were observed. Conclusion: This first prospective study on pediatric anthropometry in IMS suggests a possible increase in HC compared to WHO standards without an increase in irreversible developmental abnormalities. The observations are exploratory and require confirmation with larger prospective studies in diverse groups of MS patients. Keywords: Anthropometry, infant developmental outcomes, pediatric growth Date received: 10 October 2019; revised: 27 December 2019; accepted: 8 January 2020. Correspondence to: M Houtchens, Ann Romney Center for Neurological Diseases, Brigham and Women’s Hospital, Harvard Medical School, 60 Fenwood Road, Boston, USA. mhoutchens@bwh.harvard. edu Tatenda Dawn Mahlanza Maria Claudia Manieri Christopher Severson James Stankiewicz Tanuja Chitnis Maria Houtchens Ann Romney Center for Neurological Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Eric C Klawiter Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Andrew J Solomon Department of Neurology, University of Vermont Medical Center, Burlington, USA Ellen Lathi Joshua Katz Elliot Lewis Center for Multiple Sclerosis Care, Wellesley, USA Carolina Ionete Idanis Berriosmorales Department of Neurology, University of Massachusetts, Worcester, MA, USA Ann Cabot Department of Neurology, Concord Hospital, Concord, NH, USA Michael Elkort Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Riley Bove Weill Institute for the Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA 904545MSJ 0 0 10.1177/1352458520904545Multiple Sclerosis JournalTD Mahlanza, MC Manieri research-article2020 2020 Original Research Paper