Research suggests pregnancy does not increase the risk of serious myasthenia gravis flare-ups, but the postpartum period may pose a higher risk for some women, according to a study published in Neurology.
Myasthenia gravis is a chronic autoimmune disease that causes muscle weakness, affecting the voluntary muscles. Symptoms can include eyelid drooping, double vision, slurred or low-volume speech, trouble chewing and swallowing, and weakness in the neck, arm, and leg muscles. For women with myasthenia gravis, pregnancy has long been a concern, as previous small studies had conflicting results, leading many to choose not to have children due to fear that the disease would worsen during or after pregnancy.
However, a recent study published in Neurology suggests that pregnancy is not associated with an increased risk of serious flare-ups of the disease or new or worsening symptoms. The study, which examined a Swedish registry for people with myasthenia gravis, looked at the records of female participants who had pregnancies that reached at least 22 weeks from 1987 to 2019. A total of 112 participants with 176 pregnancies were included in the study.
The researchers found that participants were not more likely to be hospitalized for the disease during pregnancy than in the year before pregnancy. For those who did have hospitalizations, there was no increased risk of longer hospitalizations during pregnancy. However, for the year after birth, there was overall no increased risk of hospitalization, although the length of hospitalization increased compared to the year before pregnancy for those who were hospitalized.
According to the study's author, Anna Rostedt Punga, MD, Ph.D., of Uppsala University in Sweden, this is wonderful news for women with myasthenia gravis. "It's reassuring to see that pregnancy did not lead to an increase in serious flare-ups and, for the majority of women, that was also true in the months after birth," she said. The study's findings suggest that nearly 90% of women had no hospital admissions related to myasthenia gravis in their first year after birth.
While the study's results are promising, it is essential to note that a small percentage of women may still experience serious flare-ups during the postpartum period. The study found that 19 pregnancies, or 11%, in 16 participants required at least one hospital admission for myasthenia gravis in the first year after birth, compared to 12 pregnancies, or 7%, in 11 participants in the year before pregnancy. After adjusting for other factors that could affect the risk of flare-ups, the researchers found that women were five times more likely to have a flare-up in the postpartum period than during the year before pregnancy.
The study's findings have significant implications for women with myasthenia gravis who are considering pregnancy. While the risk of serious flare-ups during pregnancy is low, it is crucial for women to be aware of the potential risks and to work closely with their healthcare providers to manage their condition. By doing so, women with myasthenia gravis can minimize their risk of complications and have a healthy pregnancy.
In conclusion, the study's results provide reassurance for women with myasthenia gravis who are considering pregnancy. While the postpartum period may pose a higher risk for some women, the overall risk of serious flare-ups during pregnancy is low. As research continues to uncover the complexities of myasthenia gravis, women with the condition can feel more confident in their ability to manage their disease and have a healthy pregnancy.
