Department of Medical Sciences, Clinical Neurophysiology, Uppsala University, Uppsala, Sweden.
Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Eur J Neurol. 2024 Jan;31(1):e16100. doi: 10.1111/ene.16100. Epub 2023 Oct 16.
Few large-scale studies examine whether maternal myasthenia gravis (MG) is a risk factor for complications during pregnancy and childbirth. This study evaluated whether maternal MG is associated with an increased risk of adverse pregnancy, delivery, and neonatal outcomes.
We conducted a nationwide Swedish register-based cohort study of women who gave birth to singleton infants (≥22 gestational weeks) during 1987-2019. Exposed women were diagnosed with MG before or during the index pregnancy (N = 443). Unexposed women comprised 4249 women without a diagnosis of MG, matched for age, parity, hospital, and year of childbirth. The risks of adverse pregnancy, delivery, and neonatal outcomes for women with MG were estimated using regression modeling and presented as adjusted odds ratios (aOR).
There was no increased risk of pregnancy complications in women with MG. Women with MG had a spontaneous onset of labor less often than women without MG (69.8% vs. 79.5%; aOR 0.59; p < 0.001) as well as higher labor induction rates and elective cesarean section deliveries (16.0% vs. 12.3%, aOR 1.42; p = 0.02 and 12.0% vs. 8.1%, aOR 1.59; p = 0.009). Infants of women with MG were born on average 2 days earlier (p = 0.002); however, these infants did not have a higher risk of having low APGAR, being small for gestational age, or having a congenital malformation.
This first nationwide study of pregnancy in women with MG in Sweden demonstrates reassuring results overall, suggesting generally safe pregnancy outcomes for women with MG and their infants.
鲜有大规模研究探讨母体重症肌无力（MG）是否为妊娠和分娩期间并发症的危险因素。本研究评估了母体 MG 是否与不良妊娠、分娩和新生儿结局风险增加相关。
我们开展了一项全国性瑞典基于登记的队列研究，纳入 1987 年至 2019 年间分娩单胎活婴（≥22 孕周）的女性。暴露组女性在指数妊娠前或期间被诊断为 MG（N=443）。未暴露组包括 4249 名未诊断为 MG 的女性，按照年龄、产次、医院和分娩年份进行匹配。采用回归建模评估 MG 女性不良妊娠、分娩和新生儿结局的风险，并呈现校正比值比（aOR）。
MG 女性妊娠并发症风险无增加。MG 女性自发临产的比例低于无 MG 女性（69.8% vs. 79.5%；aOR 0.59；p<0.001），临产诱导率和选择性剖宫产分娩率更高（16.0% vs. 12.3%，aOR 1.42；p=0.02 和 12.0% vs. 8.1%，aOR 1.59；p=0.009）。MG 女性的婴儿平均提前 2 天出生（p=0.002）；然而，这些婴儿的 APGAR 评分低、小于胎龄儿或存在先天性畸形的风险并未增加。
本项瑞典首次针对 MG 女性妊娠的全国性研究总体结果令人安心，提示 MG 女性及其婴儿的妊娠结局通常安全。
