Maternal health and obstetric complications of genetic neuromuscular disorders in pregnancy: A systematic review

IF 1.9 4区 医学 Q2 OBSTETRICS & GYNECOLOGY European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-01-01 Epub Date: 2024-11-28 DOI:10.1016/j.ejogrb.2024.11.046
H. Shafeeq Ahmed , Advait Teli , Kaarvi Khullar , Bethineedi Lakshmi Deepak
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Abstract

Background

Genetic neuromuscular disorders affect muscle function and control by the nervous system, presenting significant clinical challenges, particularly during pregnancy.

Objectives

To systematically review the literature on the obstetric outcomes and complications in women with genetic neuromuscular disorders.

Search strategy

We searched PubMed/Medline, Scopus, and CINAHL Ultimate from inception till June 2024 using terms like “pregnancy”, “genetic neuromuscular disorder”, “myotonic dystrophy”, “maternal health” etc.

Selection criteria

Pregnant women with genetic neuromuscular disorders.

Data collection and analysis

Screening, selection, and data extraction were performed independently by two reviewers.

Main Results

A total of 28 studies from 1978 to 2023 examined pregnancy outcomes in women with genetic neuromuscular disorders. The disorders included myotonic dystrophy, spinal muscular atrophy (SMA), Charcot-Marie-Tooth disease (CMT), and others. Common complications were polyhydramnios, preterm labor, miscarriages, and cesarean sections. Myotonic dystrophy type 1 (DM1) showed higher neonatal risks than type 2 (DM2). Women with SMA faced exacerbated muscle weakness, while CMT and limb-girdle muscular dystrophy were associated with preterm labor and cesarean deliveries. Pompe disease exacerbated symptoms, and GNE myopathy showed similar pregnancy outcomes to the general population. Non-dystrophic myotonias had higher fetal distress and postpartum complications.

Conclusions

Women with genetic neuromuscular disorders face increased pregnancy complications, including preterm labor, cesarean sections, and disease symptom exacerbation. Multidisciplinary care between neurologists and obstetricians is essential in managing these high-risk pregnancies effectively, ensuring better maternal and neonatal outcomes. Further research is needed to develop standardized care protocols and improve clinical management.
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妊娠期遗传神经肌肉疾病的孕产妇健康和产科并发症:系统综述
遗传神经肌肉疾病影响神经系统的肌肉功能和控制,提出了重大的临床挑战,特别是在怀孕期间。目的系统回顾有关女性遗传性神经肌肉疾病的产科结局和并发症的文献。检索策略:我们检索了PubMed/Medline、Scopus和CINAHL Ultimate,检索时间从网站成立到2024年6月,检索词包括“妊娠”、“遗传性神经肌肉疾病”、“肌强直性营养不良”、“孕产妇健康”等。数据收集和分析筛选、选择和数据提取由两名审稿人独立完成。从1978年到2023年,共有28项研究检查了遗传性神经肌肉疾病妇女的妊娠结局。这些疾病包括肌强直性营养不良、脊髓性肌萎缩症(SMA)、腓骨肌萎缩症(CMT)等。常见的并发症有羊水过多、早产、流产和剖宫产。1型肌强直性营养不良(DM1)的新生儿风险高于2型(DM2)。患有SMA的妇女面临着加剧的肌肉无力,而CMT和肢带肌营养不良与早产和剖宫产有关。庞贝病加重了症状,GNE肌病的妊娠结局与一般人群相似。非营养不良性肌强直有较高的胎儿窘迫和产后并发症。结论:遗传性神经肌肉疾病妇女妊娠并发症增加,包括早产、剖宫产和疾病症状加重。神经科医生和产科医生之间的多学科护理对于有效管理这些高危妊娠至关重要,确保更好的孕产妇和新生儿结局。需要进一步的研究来制定标准化的护理方案和改善临床管理。
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来源期刊
CiteScore
4.60
自引率
3.80%
发文量
898
审稿时长
8.3 weeks
期刊介绍: The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.
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