Behind the Science: Pregnancy and Multiple Sclerosis– What’s the link?

Women's Health Blog
3 min readDec 15, 2023

Interviewees: Pia Campagna, Postdoctoral Fellow, Monash University, Melbourne, Australia Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinators)

Published: December 15th, 2023

When there are clear sex differences in disease prevalence, researchers must question the underlying factors. Women with Multiple Sclerosis (MS) outnumber men 4 to 1. What is being done to understand this statistic? How can we look into female-specific factors to disentangle these questions?

For this month’s Behind the Science, we interviewed Pia Campagna who provided some insight into these questions.

Can you tell us about your research?

Our lab studies Multiple Sclerosis (MS) and other neuro-immunological conditions. Much of my work focuses on incorporating women’s health into MS research by looking at pregnancy and menopause. MS affects 2 million people globally, roughly 75% of which are women. Previous work from our group has shown the clinical effect of pregnancy, where a pregnancy before disease onset delays the onset of MS symptoms by 3.4 years. After onset, the effect of pregnancy is more controversial, but work from our group has shown a protective effect of pregnancy on long-term disability accumulation.In my postdoc, I’m seeking to understand the biological mechanisms underpinning these clinical effects via a national multi-site prospective study.

Why did you want to get involved in women’s health?

I started research in MS due to the demographic of those affected — women. Because of this, it’s an interesting population to study in light of all of the female-specific experiences that interact with this disease. For example, it’s a disease that’s primarily diagnosed in a woman’s reproductive years (20–40 years old) so there are interactions with pregnancy, and due to the chronic nature, women are living with MS during perimenopause and menopause too.

I started my Ph.D., focused on genomics, prognostic modelling and machine learning in MS. It just so happened that other people in our group were doing this fascinating work on pregnancy. I had the opportunity to delve into the epigenetic impacts of pregnancy in women with MS, which sparked my interest in women’s health route MS. I did love the bioinformatic aspects of my Ph.D. work and hope to incorporate that down the line when we have the data available.

Is there anything interesting that you’ve learned from your research findings?

When we compared the whole blood DNA methylation profiles of women with MS who had not given birth, we identified differences in methylation patterns at genes enriched in neurogenesis and axon guidance pathways. After noticing these signals, we hypothesized that the hormonal changes from pregnancy created long-term effects that drive changes to the clinical course of MS. Now, we are collecting blood from women with and without MS before, during and after pregnancy, so eventually we’ll be able to look at DNA methylation in these different stages, as well as a range of other -omic profiles.

What impact do you hope to see with this work in the long term?

Not only is the prevalence of MS increasing worldwide but so is the female-to-male ratio. I hope that research focuses more on the female-specific aspects of the disease, which is still very understudied. Although there’s strong evidence that pregnancy is beneficial before onset, and some evidence of a beneficial long-term effect, , it’s surprising to me that we still don’t know how or why. Detangling this will not only be beneficial to women but also more individualized therapeutic targets benefit men as well. Another frontier in MS research that I would like to see more of is the impact of menopause. For example, we still don’t know if the disease gets worse after menopause, how estrogen loss interacts with disease-modifying therapies, or whether they’re as effective. Understanding the clinical aspects of menopause and subsequently, the biological aspects of menopause is an important route to take moving forward.

Where can people learn more about your work?



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