Can neonatal myasthenia gravis be predicted?

Aim: To determine any association between history of mothers with myasthenia gravis (MG) and the occurrence of neonatal myasthenia gravis (NMG). Methods: The prospective study involved pregnant women with MG and their newborns delivered in our center throughout the nine-year period. The study included 16 newborns with NMG and 33 healthy newborns without symptoms of NMG. Their outcome was evaluated in relation to the duration of the illness (<5, 5-10, >10 years) and maternal therapy (no therapy, mestinon, corticosteroid, or combination of the two). Results: The duration of maternal illness and type of therapy were not predictive of neonatal outcomes (P=0.159, and P=0.578, respectively). Conclusion: The duration of illness and therapy of women with MG do not correlate with manifestation of NMG and do not predict which pregnancies would result in an affected child. Because of possible severe, unpredictable, and life threatening NMG, these births should be carried out in a tertiary birth center.