Neonatal Outcome in Pregnancies with Autoimmune Myasthenia Gravis

Abstract

Newborns of mothers with MG manifest clinical features of TNM relative to stage of mother's illness. These newborns need monitoring until the seventh day of life.

Juvenile myasthenia gravis in Norway: A nationwide epidemiological study

“…This occurs in approximately 10 -15 % of births in females with MG (68,69). Symptoms like hypotonia, feeding difficulties, weak cry or respiratory distress, manifest within the first 3 days of life and last 2-4 weeks in general (29,70). Treatment is symptomatic with acetyl cholinesterase inhibitor, assisted ventilation or IVIg, however, rarely needed.…”

Risk factors associated with adverse pregnancy outcomes and postpartum exacerbation in women with myasthenia gravis

“…More male newborns developed transient myasthenia (33/62) than females (29/62) ( p = .079) in Jovandaric's research. Male gender seemed to be an independent risk factor for adverse pregnancy outcomes in a retrospective study, 39,40 though the underlying mechanism awaits exploration. Hoff 41 demonstrated children with neonatal MG were more likely to display signs of fetal distress during delivery ( p = .05), while most babies with fetal distress did present TNMG in our study but without significant difference ( p = .076).…”

Newborn from the third deed with severe Transient Neonatal Myasthenia Gravis: Case report

“…Myasthenia gravis is an autoimmune disease where antibodies attack the postsynaptic membrane of the neuromuscular junction causing muscular weakness and progressive fatigue. 2,3 In women, the incidence has a maximum peak between the second and third decades of life, which matches the fertility period. 5 Affection to the newborn occurs vertically through the transplacental pass of antibodies.…”

“…Myasthenia gravis (MG) is a disease that affects the neuromuscular junction causing muscular weakness. 1,2 In the neonatal period we can identify two types: congenital MG, caused by a genetic defect, and Transient Neonatal Myasthenia Gravis (TNMG), 3 that presents in 10-20% of the newborns of a mother with MG. 1 The reason why it doesn´t present in all the newborns of a mother with MG is not well known, there is no way to predict if a newborn will be affected by the disease, and the disease itself is not related with the severity of the mother´s disease or her antibody titers. 4 The only association that has been found according to some studies is a protective effect of thymectomy in the mother, on the risk for a newborn to develop TNMG.…”