Neurofilament light chain levels in pregnant multiple sclerosis patients: a prospective cohort study.

BACKGROUND AND PURPOSE: Neurofilament light chain is a cytoskeletal protein of neurons. Its levels are increasingly recognized as measures of neuroaxonal damage. The aim of this study was to explore serum neurofilament light chain (sNfL) levels in multiple sclerosis (MS) patients and healthy controls during pregnancy and puerperium. METHODS: This was a prospective, longitudinal, single-center study. sNfL concentration was assessed using a highly sensitive single-molecule array during pregnancy and in puerperium, in a cohort of 39 pregnant patients with relapsing multiple sclerosis (P-MS). Twenty-one healthy pregnant women (HPW) served as a control group. Eight P-MS suffered relapses during pregnancy (P-MS-R) in the first or second trimesters. RESULTS: No differences in pregnancy and delivery data were observed between P-MS and HPW. P-MS showed higher sNfL values than HPW in the first trimester, independently of the presence (P = 0.002) or not (P = 0.02) of relapses during pregnancy. However, in the third trimester, only P-MS-R showed higher sNfL values than HPW (P = 0.001). These differences extended to the puerperium, where P-MS-R showed higher sNfL values than those with no relapses during gestation (P = 0.02). CONCLUSION: These data strongly suggest that sNfL levels reflect MS activity during pregnancy. Additionally, the absence of relapses during pregnancy may have a beneficial effect on neurodegeneration during puerperium.

[An analysis of indications for performing cesarean section from material of the Obstetric-Gynecologic Wards I and II of the District General Hospital in Radom in 1985-1993]. / Analiza wskazan do ciecia cesarskiego w materiale Oddzialów Polozniczo-Ginekologicznych I i II Wojewódzkiego Szpitala Zespolonego w Radomiu w latach 1985-1993.

In 1985-1993 there were 37,046 deliveries in the Maternity and Gynaecological Ward of District General Hospital in Radom. In 4873 (13.15%) cases the caesarean section (c.s) was performed. Primiparas constituted 39.3% and the repeated c.s. was carried out on 1160 (39.2%) patients. In the analysed period the increase in percentage of the c.s. was observed from 11.79% in 1985 to 14.81% of the total number of deliveries in 1993. The most frequent indications to perform the c.s. were the imminent intrauterine asphyxia of the fetus--25.36%, the abnormal position of the fetus--17.73% and the nonprogressive labour--9.89%. In all these groups the operations were performed in over 70% of primiparas. In the case of multiparas the indications to operate were: prolapse of the loop of umbilical cord--71%, placenta previa in 85.8% and the prematurely detached placenta in 72.2% of cases. In 4.45% of cases the c.s. was performed as the result of other than obstetric indications.