Myasthenia gravis: consequences for pregnancy, delivery, and the newborn.
OBJECTIVE
To investigate the effect of maternal myasthenia gravis (MG) on giving birth and on the newborn.


METHODS
A retrospective cohort study for 1967 through 2000 was undertaken, using data from the Medical Birth Registry of Norway, based on the compulsory notification of all births. The target group consisted of 127 births by mothers with MG. The reference group consisted of all 1.9 million births by mothers without MG.


RESULTS
Women with MG had a higher rate of complications at delivery (40.9% vs 32.9%, p = 0.05), and in particular the risk of preterm rupture of amniotic membranes was three times higher in the MG group compared to the reference group (5.5% vs 1.7%, p = 0.001). The rate of interventions during birth was raised (33.9% vs 20.0%, p < 0.001) and cesarean sections doubled (17.3% vs 8.6%, p = 0.001). Five children (3.9%) born by MG mothers had severe anomalies, and three of them died.


CONCLUSIONS
MG is associated with an increased risk for complications during delivery. This is linked to a higher occurrence of interventions during birth.
Hoff
Jana Midelfart
JM
Institute of Neurology, Department of Public Health and Primary Health Care, University of Bergen, Norway.
Daltveit
Anne Kjersti
AK
Gilhus
Nils Erik
NE
D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009157:Myasthenia Gravis / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000601:surgery; D011256:Pregnancy Outcome; D012189:Retrospective Studies