Proposing Strategies to Increase Pregnancy-Related Awareness Among Multiple Sclerosis Patients in Iran

Document Type : Letter to Editor


1 Multiple Sclerosis (MS) Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

2 The London School of Economics and Political Science, London, England


Main Subjects

Dear Editor,

Multiple sclerosis (MS) is a neurodegenerative and potentially disabling condition of the central nervous system affecting young adults. Numerous women living with MS still wonder whether they will be able to have children and what difficulties they could encounter. Currently, there is no official medical guidelines for female MS patients planning to conceive, the issue remains an unmet medical need (1). There has long been debate over how gestation affects MS. Several studies have demonstrated that gestation has an immunoprotective role in multiple sclerosis (MS) (2). However, some research shows increased relapse rates following delivery (3). The frequency of MS is increasing worldwide as well as in Iran. In Iran, there are 100 cases of MS for every 100,000 people which is a significant prevalence (4). MS is more frequently diagnosed during the childbearing age of women. According to the most recent studies in Iran, the patients’ knowledge about MS is insufficient (5). Especially in rural communities, due to the dearth of sexual and health education, unplanned pregnancies are more common in general and in MS patients.

The absence of formal guidelines and a lack of health education have caused several medical and social issues for MS patients who intend to get pregnant and/or already are. For instance, many patients in rural areas quit taking their medication during pregnancies which exacerbates the issue and usually causes progression of the MS. On the other hand, some individuals are better informed but still don't have a full understanding of their situation, many of these people put off pregnancy due to the concerns about the pregnancy, some of which are unjustified. There is currently no government or state support for patients suffering from MS in Iran, and very little is being done to increase public awareness of MS in general. Hence, there is a severe dearth of understanding in society regarding MS patients and the effects of pregnancy on them.

Now “'Iran MS Society” at the moment is the sole NGO/Charity in Iran that actively supports patients suffering from MS and promotes awareness of their issues. While the majority of society's efforts are currently directed toward providing financial assistance, we think there should be a greater emphasis on raising public awareness, particularly concerning issues involving MS and pregnancy.

According to this paper, this could be accomplished by setting up an office focused on promoting accurate information on this issue. This could be performed via social media as well as traditional media outlets. Multiple social media platforms are available for potential utilization. Among these platforms, Instagram stands out as the most commonly used application among Iranian women and youth. However, it is worth noting that several other social media platforms, such as Telegram and WhatsApp, are also wildly in use used and may offer patients a greater sense of security. Nevertheless, it is important to acknowledge that Instagram possesses a significantly broader user base compared to any other platform.

However, what is crucial is regular and ongoing efforts to connect the public with healthcare professionals. A neurologist with expertise in MS can address questions related to the impact of MS on pregnancy, potential risks, disease management during pregnancy, and the safety of MS medications during this period. Additionally, if available, the presence of a multidisciplinary team, comprising obstetricians, neurologists, and other relevant healthcare professionals, would be highly beneficial. This team-based approach ensures comprehensive care and allows for collaborative decision-making to optimize the health outcomes of pregnant women with MS.

It would be helpful if workshops or open meetings were held once a month or regularly, in the style of town halls where participants could ask any questions of the experts.

The most remote and rural areas must be considered for hosting these meetings and workshops. The advantages of addressing issues and concerns pertaining to Multiple Sclerosis (MS) and pregnancy through expert guidance are evident. By increasing awareness and providing accurate information, these interventions serve to clarify misconceptions and dispel misinformation. Consequently, pregnant women affected by MS are empowered to make informed medical decisions, armed with a more precise understanding of the potential challenges they may encounter. Such interventions play a critical role in the prevention of medical complications and are essential for promoting optimal health outcomes.

Social media can also be helpful in these circumstances by enabling professionals to maintain contact with patients and/or caregivers. This would raise public awareness and prevent many avoidable medical and non-medical issues that could cost the individual, family, and society.

The proposition of organizing small workshops facilitated by medical professionals in public buildings or parks is an intriguing approach to community engagement in Iran. This strategy holds the potential to effectively reach out to various segments of the population. By utilizing female-only designated parks, it becomes possible to target women who may have limited social interactions in their day-to-day lives. This tailored approach ensures the creation of a comfortable and inclusive environment, allowing these women to actively participate and gain knowledge on critical medical topics.

To maximize the effectiveness and reception of such workshops, it is essential to carefully consider the specific requirements, needs, and preferences of the target audience. By doing so, organizers can ensure that the content and format of the workshops align with the unique circumstances and expectations of the participants. This approach will enhance the overall impact of the workshops and contribute to the dissemination of valuable medical information within the community.

Government and public support are necessary for such programs. In addition to direct state action, the government must develop incentives for nonprofit organizations and pharmaceutical firms to motivate them to continue advancing public health.





We do not have any financial support for this study.

Conflict of interest

The authors declare no conflict of interest regarding the publication of this paper.

Ethical approval

No need

Consent for publication

 This manuscript has been approved for publication by all authors.

1. Borisow N, Paul F, Ohlraun S, Pach D, Fischer F, Dörr J. Pregnancy in multiple sclerosis: a questionnaire study. PLoS One. 2014;9(6):e99106.
PMid:24901447 PMCid:PMC4047092
2. McCombe PA. The short and long-term effects of pregnancy on multiple sclerosis and experimental autoimmune encephalomyelitis. Journal of Clinical Medicine. 2018;7(12):494.
PMid:30486504 PMCid:PMC6306813
3. Jacques FH, Lublin FD. Defining the clinical course of multiple sclerosis: The 2013 revisionsAuthor Response. Neurology. 2015;84(9):963-.
4. Mirmosayyeb O, Shaygannejad V, Bagherieh S, Hosseinabadi AM, Ghajarzadeh M. Prevalence of multiple sclerosis (MS) in Iran: a systematic review and meta-analysis. Neurological Sciences.
5. Hosseini Z, Homayuni A. General knowledge and Attitudes towards Multiple Sclerosis in Isfahan in 2021. Tolooebehdasht. 2022;20(6):1-14.
Volume 3, Issue 1
January 2024
Pages 1-2
  • Receive Date: 26 July 2023
  • Revise Date: 25 September 2023
  • Accept Date: 25 September 2023