Will my baby be healthy?

Overall the risk of birth defects is not increased for women with MG and is comparable to pregnancies of women without MG. A rare birth defect that has been linked to MG is arthrogryposis, which refers to muscle weakness and joint deformities that are present at birth. Women who have large amounts of a specific type of antibody that targets the infantile form of the acetylcholine receptor are more likely to deliver babies with arthrogryposis. The fortunate feature is that women who deliver babies with arthrogryposis usually do not have clinical MG. The subset of antibodies that cause arthrogryposis, do not cause symptoms in adults. Consequently, women who have MG are not likely to have babies with arthrogryposis.

Severe arthrogryposis can be recognized by ultrasound prior to delivery. One health concern that women with MG and their doctors must consider is transient neonatal MG (TNMG). TNMG occurs when MG antibodies are transferred from the mother to the baby and can be effectively addressed if anticipated. The baby will need treatment, perhaps for several days to a week, until the MG antibodies from the mother have been removed from the baby or spontaneously broken down. Babies who have had TNMG have grown to be normal children.

How will my MG treatment complicate my ability to get pregnant?

Women need to consider several issues and have extensive discussion with their physicians and other women who have been pregnant before they attempt pregnancy. As pregnancy advances, women frequently feel fatigued. Fatigue can be more prominent in women with MG. Treatment with anticholinesterase medications, such as pyridostigmine (mestinon®), does not affect the ability of an individual to become pregnant nor is it known to appreciably complicate a woman’s ability to carry a pregnancy.

There is slight risk of anticholinesterase medication triggering or enhancing uterine contractions. Many people with MG are treated with medications that alter the immune system, immunosuppressive agents. Immunosuppressive agents include glucocorticoids, such as prednisone, azathiaprine, mofetil mofetate (CellCept®), cyclosporine and other agents. It is essential if you are taking a medication or treatment to alter your immune system that you discuss the risks associated with getting pregnant when using that treatment. In general glucocorticoids can be continued during pregnancy.

How will pregnancy affect my MG?

About a third of women with MG will have a flare of their MG during the first trimester of pregnancy. In general, MG symptoms, with the exception of general fatigue, tend to decline during the second and third trimesters of pregnancy. As pregnancy advances, breathing during sleep can be compromised in any pregnant woman. Because disorders of sleep, particularly sleep apnea, are often under-recognized in people who have MG, women contemplating pregnancy should discuss with their caregivers whether they should have a sleep study to evaluate their breathing when asleep. The usual treatment for sleep apnea, continuous positive airway pressure

(CPAP), does not complicate pregnancy.

来自，美国MG基金会网站

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