Most women with myasthenia gravis (MG) can have safe vaginal deliveries, according to a recent study published in the journal Neurology.
MG is an autoimmune disorder that affects how nerves and muscles communicate, leading to weak muscles and fatigue. Because it often occurs in women of childbearing age, researchers wanted to see how it impacts childbirth and newborn health.
This study looked at all single-baby births recorded in Norway’s birth registry between 1999 and 2022, comparing women with MG to those without.
Most women with MG gave birth vaginally, and their risk of emergency C-sections or deliveries assisted with tools like a vacuum or forceps was similar to other mothers. Planned (elective) C-sections were twice as common in women with MG (11% compared to 6%), and labor was more often started with medical help (26% vs. 18%).
Although guidelines recommend C-sections only when medically necessary, about one-third of C-sections in women with MG were done at the mother’s request or because of concerns about her condition. The researchers noted that some healthcare providers may worry MG could make vaginal delivery harder. However, the results show most vaginal births were uncomplicated.
Women with MG had a slightly higher chance of water breaking early, needing an episiotomy (a small surgical cut to help delivery), needing pain relief like an epidural, having smaller babies and staying in the hospital longer after delivery.
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Among babies born to mothers with MG, serious breathing problems were rare, and no birth defects were seen. About 4% of newborns were diagnosed with transient neonatal MG (TNMG), a short-term condition caused by the mother’s antibodies affecting the baby.
“We believe that TNMG was under-recognized because 40% of children of mothers with MG had hypotonia [low muscle tone] and feeding problems or required care in a neonatal unit,” the researchers said. “This highlights the need to increase awareness and general knowledge of TNMG among health care providers caring for women with MG and their newborns.”
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