Abstract

Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system, characterized by inflammation, demyelination, and neurodegeneration. Pregnancy often induces fluctuations in disease activity, with many women experiencing temporary remission during gestation followed by an increased risk of relapse in the postpartum period. This review explores the intricate relationship between pregnancy and disease progression in MS patients, focusing on the immunological changes that occur during gestation and their impact on MS activity. The "pregnancy effect," characterized by a reduction in disease activity during pregnancy, is believed to stem from the maternal immune system's shift towards an anti-inflammatory state to tolerate the developing fetus. However, the abrupt reversal of these immunological changes postpartum may lead to a resurgence of disease activity. Clinical management strategies, including close monitoring, preconception counseling, and tailored treatment approaches, are essential for optimizing care during pregnancy and minimizing postpartum relapse risk