title: The Impact of Pregnancy on Myotonic Dystrophy: A Registry-Based Study.
abstract: BACKGROUND
  The rate of symptom progression during pregnancy in myotonic dystrophy (DM) is not currently known. Further, there is little data regarding the rate of pregnancy complications and neonatal outcomes in DM.
  
  
  OBJECTIVE
  This study assesses symptom progression and complication rates during pregnancy in women with DM.
  
  
  METHODS
  DM women completed surveys regarding their prior pregnancies. Participants identified complications during their pregnancies and completed the Myotonic Dystrophy Health Index-Short Form (MDHI-SF) to measure their disease burden and identify the severity of select symptoms six-months prior to, during, and six-months after their first pregnancy.
  
  
  RESULTS
  152 women with DM reported on 375 pregnancies. Among these pregnancies, there was a 32.5% miscarriage rate. Some complications were common including: pre-term labor (27.8%), pre-eclampsia (10.4%), and peripartum hemorrhage (13.9%). Participants' perception of their mobility and ability to perform activities, as measured by the MDHI-SF, worsened during pregnancy and did not recover during the post-partum period.
  
  
  CONCLUSIONS
  Miscarriage, maternal disease progression during pregnancy, and other pregnancy related complications may occur in DM. Women with DM should be counseled on these potential risks prior to considering pregnancy.
authors.affiliation: Department of Neurology, The University of Utah, UT, USA.
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Johnson
authors.affiliation: Department of Orthopaedics, The University of Utah, UT, USA.|Division of Epidemiology, The University of Utah, UT, USA.|Division of Public Health, The University of Utah, UT, USA.
authors.forename: Man
authors.initials: M
authors.lastname: Hung
authors.affiliation: The Myotonic Dystrophy Foundation, CA, USA.
authors.forename: Eriko
authors.initials: E
authors.lastname: Nasser
authors.affiliation: The Department of Neurology, Stanford University, CA, USA.
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Hagerman
authors.affiliation: Division of Epidemiology, The University of Utah, UT, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: The Department of Neurology, University of Rochester, NY, USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Ciafaloni
authors.affiliation: The Department of Neurology, University of Rochester, NY, USA.
authors.forename: Chad R
authors.initials: CR
authors.lastname: Heatwole
keywords: Myotonic dystrophy; neuromuscular disease; patient reported outcomes; pregnancy complications