先天性新生儿肌无力：改良重症肌无力女性患者所生婴儿的发病风险评估。
Transient neonatal myasthenia gravis: refining risk estimate for infants born to women with myasthenia gravis.
机构信息
Department of Pediatrics, Neonatal-Perinatal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
出版信息
J Perinatol. 2021 Sep;41(9):2279-2283. doi: 10.1038/s41372-021-00970-6. Epub 2021 Feb 17.
OBJECTIVE
Transient neonatal myasthenia gravis (TNMG) can render a neonate vulnerable to catastrophic respiratory depression. Our aim was to describe the clinical manifestations of TNMG, and to determine when the myasthenic signs become apparent in TNMG.
METHODS
We reviewed our own experience of infants who underwent routine inpatient monitoring for TNMG and combined our local data with observations from previous studies.
RESULTS
Only three case series (n = 110) reported both the type and timing of onset of myasthenic signs. Adding local data (n = 37) yielded 147 infants born to women with MG. Fifteen infants (10%) developed signs of TNMG with onset being 1.5 ± 2.6 days (mean ± 3SD) after birth. Feeding difficulties and low tone were the commonest presenting signs, and only 1 of the 147 infants needed intubation for hypoventilation.
CONCLUSIONS
TNMG signs were mostly not life-threatening. We suggest only 4 days of routine postnatal observation for infants born to women with MG.
目的
短暂性新生儿肌无力（TNMG）可使新生儿易发生灾难性呼吸抑制。我们的目的是描述 TNMG 的临床表现，并确定 TNMG 中的肌无力征象何时变得明显。
方法
我们回顾了我院接受常规住院监测的 TNMG 婴儿的经验，并将本地数据与先前研究的观察结果相结合。
结果
仅有 3 个病例系列（n=110）报告了肌无力征象的类型和发生时间。加入本地数据（n=37）后，共纳入了 147 例患有 MG 的女性所生婴儿。15 例婴儿（10%）出现 TNMG 征象，出生后 1.5±2.6 天（均值±3SD）出现。喂养困难和低张力是最常见的表现，147 例婴儿中仅有 1 例因通气不足需要插管。
结论
TNMG 征象大多没有生命危险。我们建议对患有 MG 的女性所生婴儿仅进行 4 天的常规产后观察。
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