Outcome of Myasthenia Gravis Mothers and Their Infants

重症肌無力母親與其新生兒的預後

鄭弋(I Cheng) ； 林姃慧(Cheng-Hui Lin) ； 林明益(Ming-I Lin) ； 李俊賢(Jing-Sheng Lee) ； 邱浩彰(Hou-Chang Chiu) ； 穆淑琪(Shu-Chi Mu)

《Acta Paediatrica Taiwanica》 48卷3期 (2007/06) Pp. 141-145

https://doi.org/10.7097/APT.200706.0141

摘要

背景：本研究針對新光醫院重症肌無力產婦及其新生兒預後分析。
方法：本回溯性研究從1997至2005年在新光醫院生產的重症肌無力產婦醫療紀錄，包括乙醯膽鹼受器抗體的效價，藥物劑量，生產方式及產程紀錄，新生兒出生後的狀況，加以分析統計。
結果：八年內有12位重症肌無力產婦生產13次。所有的產婦都沒有因生產而需要轉入加護病房照顧。自然生產的有2人，10人剖腹生產。共有14個嬰兒出生，平均懷孕週數37.2±2.0週，平均出生體重2838.6±724.2公克。2個新生兒有先天性異常(14.2%)，一位嬰兒罹患暫時性新生兒重症肌無力(7.1%)。
結論：有38%的重症肌無力產婦疾病惡化，除了一位產婦在妊娠前三個月合併上呼吸道感染及重症肌無力惡化，其餘都是生產後疾病惡化。本院暫時性新生兒重症肌無力的發生率與國外報告相較為低。產婦乙醯膽鹼受器抗體的效價與新生兒重症肌無力的發生沒有相關性。本院重症肌無力產婦約33%接受剖腹生產，有可能避免這類產婦自然生產的併發症。

關鍵字

重症肌無力 ； 懷孕 ； 新生兒重症肌無力

並列摘要

Background: The aim of this retrospective study was to assess neonatal outcomes of pregnant women with myasthenia gravis (MG).
Methods: Pregnant women with MG who were treated in our hospital over an 8-year period were enrolled. Data relating to the course of the mother's MG (including the anti-acetylcholine receptor antibody (anti-AchR) titer and drug dosage), delivery mode, delivery course, puerperium period, and neonatal outcomes were obtained from the medical records.
Results: Twelve women with MG had 13 pregnancies in our hospital from January 1997 to December 2005. None of the mothers needed intensive care. Two patients delivered vaginally, and ten delivered by cesarean section. Fourteen infants were born at an average gestational age of 37.2±2.0 weeks; their average birth weight was 2838.6±724.2 g. Two neonates (14.2%) had a congenital anomaly. Transitory neonatal myasthenia gravis (NMG) was diagnosed in one infant (7.1%).
Conclusions: In our study, MG exacerbations occurred in 38.5% of the patients. Postpartum, all MG patients experienced deterioration except one patient who deteriorated in the first trimester with a concomitant upper airway tract infection. Only 1 of the 14 neonates developed transient NMG; the incidence of transient NMG was lower than that previously reported. There was no correlation between the occurrence of NMG and the maternal anti-AChR titer. The cesarean section rate was approximately 33%; this high rate of elective cesarean sections in these MG patients could have prevented the occurrence of some of the complications related to vaginal delivery.

並列關鍵字

myasthenia gravis ； pregnancy ； neonatal myasthenia gravis