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

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-11-28 DOI:10.1016/j.ejogrb.2024.11.046

H. Shafeeq Ahmed , Advait Teli , Kaarvi Khullar , Bethineedi Lakshmi Deepak

{"title":"Maternal health and obstetric complications of genetic neuromuscular disorders in pregnancy: A systematic review","authors":"H. Shafeeq Ahmed , Advait Teli , Kaarvi Khullar , Bethineedi Lakshmi Deepak","doi":"10.1016/j.ejogrb.2024.11.046","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Genetic neuromuscular disorders affect muscle function and control by the nervous system, presenting significant clinical challenges, particularly during pregnancy.</div></div><div><h3>Objectives</h3><div>To systematically review the literature on the obstetric outcomes and complications in women with genetic neuromuscular disorders.</div></div><div><h3>Search strategy</h3><div>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.</div></div><div><h3>Selection criteria</h3><div>Pregnant women with genetic neuromuscular disorders.</div></div><div><h3>Data collection and analysis</h3><div>Screening, selection, and data extraction were performed independently by two reviewers.</div></div><div><h3>Main Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"304 ","pages":"Pages 152-170"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of obstetrics, gynecology, and reproductive biology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0301211524006614","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

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.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

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.