Abstract
Objective
Information about pregnancy and delivery in hereditary neuromuscular disorders (NMD)
is limited and largely restricted to small case series and single case reports. Further
data of obstetric histories in clinically and genetically defined subgroups are required.
Study design
We reviewed the obstetric histories of 178 patients with myotonic dystrophy type 1
(DM1) and 2 (DM2), Charcot-Marie-Tooth disease (CMT), spinal muscular atrophy (SMA),
limb-girdle muscular dystrophy (LGMD), facioscapulohumeral muscular dystrophy (FSHD),
and congenital myopathy (CM) by means of questionnaires and medical reports. Patients
were recruited in the period 1992–2010 after they had at least completed one pregnancy.
A total of 380 pregnancies resulting in 315 children were documented.
Results
Compared to the normal German population, the number of miscarriages and hypertensive
diseases in pregnancy was not increased in the cohort. Patients with NMD delivered
more frequently by vaginal operations (8.9–18.2%) and by cesarean births with significantly
high rates in DM1 (36.7%) and SMA (42.4%). Preterm deliveries were recorded in 30.7%
of DM1, 12.6% of DM2, and 29.4% of SMA gestations. Abnormal fetal presentation occurred
significantly more frequently in DM1 (34.6%) and LGMD (26.7%) deliveries and was a
feature of chairbound patients. Considering a possible influence of pregnancy on the
disease course, about half of LGMD, one-third of SMA, and one fifth of CMT patients
reported a deterioration of symptoms in pregnancy. Neonatal outcome was favorable
in all NMD but DM1, where infantile morbidity and mortality is often but not exclusively
related to congenitally affected children.
Conclusion
Our data are important for obstetric care and genetic counseling of women with NMD
who are contemplating pregnancy.
Key words
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Article info
Publication history
Published online: March 09, 2012
Accepted:
February 20,
2012
Received in revised form:
January 27,
2012
Received:
November 5,
2011
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
