Pregnancy

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Research on outcomes of pregnancy for women with chronic fatigue syndrome is limited.

There is evidence of symptom improvement or remission in many inflammatory and autoimmune diseases during pregnancy. This may be due to hormonal or immune changes.[1]

Changes during pregnancy[edit]

Placenta[edit]

The placenta secretes progesterone and high levels of estrogen . It also contains high concentrations of diamine oxidase, an enzyme that breaks down histamine.
Pregnant non pregnant histamine ascorbic acid.jpg

Immune system[edit]

The mucosal immune system undergoes profound changes so that the mother's body won't reject the fetus. Tregs increase. TGF-beta increases. Progesterone and estrogen, which both have anti-inflammatory properties, increase.[2] The immune skews to a Th2 response.

Pregnancy and ME/CFS[edit]

Fertility[edit]

Women with chronic fatigue syndrome report higher rates of polycystic ovarian syndrome (PCOS) and anovulatory cycles, higher rates of dysmenorrhea and higher rates of endometriosis.[3]

Symptoms during pregnancy[edit]

There has been very little research on pregnancy and ME or CFS. One retrospective survey found that 41% of respondents reported no change in symptoms during pregnancy, 30% improved and 39% got worse.[4]

In clinical practice, Dr. Nancy Klimas, Dr. Lucinda Bateman, and Dr. Charles Lapp report higher rates of improvement or remission during pregnancy. Klimas reports that in the 20 women she has followed through pregnancy, improvement in symptoms during pregnancy was "almost universal" and in some cases resulted in total temporary remission. Dr. Lapp reported that 25 out of 27 patients in his practice felt better during pregnancy. Dr. Klimas suggests that improvement may be due to increased blood volume during pregnancy or hormonal changes.[5]

Postpartum[edit]

In one survey, after delivery, 30% had no change in symptoms, 20% improved, and 20% got worse. Dr. Klimas reports that her patients typically do well postpartum until about 3 to 6 months after at which time there is often a severe relapse.[6]

Complications[edit]

When comparing these women's pregnancies after illness onset to pregnancy before illness onset (but not to healthy controls), the rate of complications were similar but in pregnancies occurring after illness onset, there was a higher rate of miscarriages (30% v. 8%) and development delays or learning disabilities (21% v. 8%).[7] However, this may have been due in whole are part to maternal age (pregnancies before illness onset occurred when women were younger than pregnancies occurring after illness onset).[8]

Placenta[edit]

In a randomized, double blind, controlled trial, injections of subcutaneous human placental extract were found to improve symptoms in Chronic fatigue syndrome patients.[9]

Pregnancy in other conditions[edit]

In general, Th1 dominant immune disorders tend to improve during pregnancy while Th2 dominant immune disorders tend to worsen.[10] For example, in a study of women with rheumatoid arthritis 75% of patients experienced remission of their RA during pregnancy and 62% experienced a worsening of symptoms after delivery.[11] 92% relapse within the first three months after delivery.[12] The course of Crohn's disease and ulcerative colitis improves during and after pregnancy.[13] In relapsing-remitting multiple sclerosis, rates of relapse decrease during the first two trimesters and increase significantly postpartum.[14]

By contrast, pregnancy increases rates of lupus flares.[15] In a retrospective study of fibromyalgia patients based on personal interviews, nearly all patients surveyed experienced a worsening of symptoms during pregnancy, especially during the third trimester. Fibromyalgia did not appear to have an adverse effect on the outcome of pregnancy or the health of the baby.[16]

See also[edit]


Learn more[edit]

References[edit]

  1. http://www.sciencedirect.com/science/article/pii/S1471491413001093
  2. http://www.ncbi.nlm.nih.gov/pubmed/21488887
  3. http://www.medscape.com/viewarticle/576986_6
  4. http://archinte.jamanetwork.com/article.aspx?articleid=216675
  5. http://www.medscape.com/viewarticle/576986_6
  6. http://www.medscape.com/viewarticle/576986_6
  7. http://archinte.jamanetwork.com/article.aspx?articleid=216675
  8. http://emerge.org.au/about-mecfs/diagnosis/managing-symptoms-daily-basis/pregnancy-motherhood-mecfs/#.VkpwyrSYe6w
  9. [https://www.jstage.jst.go.jp/article/bpb/advpub/0/advpub_b15-00623/_article Human Placental Extract as a Subcutaneous Injection is effective in Chronic Fatigue Syndrome. A Multi-center, Double-Blind, Randomized, Placebo-Controlled Study], Biological and Pharmaceutical Bulletin
  10. http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.1999.tb07630.x/abstract?userIsAuthenticated=false&deniedAccessCustomisedMessage=
  11. http://www.tandfonline.com/doi/abs/10.3109/03009748309102886
  12. http://www.sciencedirect.com/science/article/pii/S1297319X09001997
  13. http://www.sciencedirect.com/science/article/pii/S1471491413001093
  14. http://www.nejm.org/doi/full/10.1056/nejm199807303390501
  15. http://rheumatology.oxfordjournals.org/content/35/2/133.short
  16. http://www.tandfonline.com/doi/abs/10.3109/03009749709065698


The information provided at this site is not intended to diagnose or treat any illness.

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history