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How safe is it to have a baby if I have myasthenia gravis? I know people do it, but what are the risks? Both to me and the baby? Will I have to go off my meds? Will i pass the disease on to my baby? I’d really like to have a baby, but i’m worried. My doc

3 doctors weighed in
Dr. Herbert Krob
Neurology
1 doctor agrees

In brief: The

The more common kind of myasthenia gravis is an acquired condition: your body is tricked into making antibodies that attack its own acetylcholine receptors on the surface of your muscles, reducing the ability of your nerves to activate them, and leading to weakness.
There is another, much rarer type of myasthenia gravis that is not acquired, but genetic. Women with acquired myasthenia gravis won't pass the disease itself on to their children, but since the myasthnia antibodies made by mom can cross the placenta into the circulation of the fetus, the fetus can be affected temporarily (mom's antibodies can stay in the baby up to several weeks after birth). This condition is called neonatal myasthenia gravis. Newborns with neonatal myasthenia can have temporary weakness of limb muscles, breathing muscles, and feeding muscles. They can also have a condition called arthrogryposis, stiff joints with limited range of flexibility because they didn't move as much in the womb as they might have otherwise. This is why it is important to have acquired myasthenia gravis well-controlled throughout pregnancy. There are many different kinds of medications used to control myasthenia. Some of them, particularly the immunosuppressants (like methotrexate, azathioprine, mycophenolate mofetic) are known to cause harm to the baby if taken during pregancy, while breastfeeding, or even prior to conception. Other treatments such as steroids and ivig are less risky (but not zero risk). Women with myasthenia who are considering pregnancy should work very closely with a team including a neurologist experienced in the treatment of myasthenia gravis, an obstetrician and a neonatologist. This is the best way to reduce worry, and risk, as much as possible. For general information about myasthenia gravis, visit the myasthenia gravis foundation of america website at www.Myasthenia.Org.

In brief: The

The more common kind of myasthenia gravis is an acquired condition: your body is tricked into making antibodies that attack its own acetylcholine receptors on the surface of your muscles, reducing the ability of your nerves to activate them, and leading to weakness.
There is another, much rarer type of myasthenia gravis that is not acquired, but genetic. Women with acquired myasthenia gravis won't pass the disease itself on to their children, but since the myasthnia antibodies made by mom can cross the placenta into the circulation of the fetus, the fetus can be affected temporarily (mom's antibodies can stay in the baby up to several weeks after birth). This condition is called neonatal myasthenia gravis. Newborns with neonatal myasthenia can have temporary weakness of limb muscles, breathing muscles, and feeding muscles. They can also have a condition called arthrogryposis, stiff joints with limited range of flexibility because they didn't move as much in the womb as they might have otherwise. This is why it is important to have acquired myasthenia gravis well-controlled throughout pregnancy. There are many different kinds of medications used to control myasthenia. Some of them, particularly the immunosuppressants (like methotrexate, azathioprine, mycophenolate mofetic) are known to cause harm to the baby if taken during pregancy, while breastfeeding, or even prior to conception. Other treatments such as steroids and ivig are less risky (but not zero risk). Women with myasthenia who are considering pregnancy should work very closely with a team including a neurologist experienced in the treatment of myasthenia gravis, an obstetrician and a neonatologist. This is the best way to reduce worry, and risk, as much as possible. For general information about myasthenia gravis, visit the myasthenia gravis foundation of america website at www.Myasthenia.Org.
Dr. Herbert Krob
Dr. Herbert Krob
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Dr. Simon Fishman
Neurology

In brief: Myasthenia

Commonly, woman with autoimmune disease have less symptoms of their disease during pregnancy. The complications are related to weaning medications before you get pregnant and during delivery. Some of the medications used to control myasthenia can be dangerous to a fetus in early pregnancy. I usually recommend woman to use ivig to control the disease before getting pregnant. Given the risks associated with delivery (mostly the high risk of c-section) i would recommend you visit a high risk obstetrics practice before you get pregnant.

In brief: Myasthenia

Commonly, woman with autoimmune disease have less symptoms of their disease during pregnancy. The complications are related to weaning medications before you get pregnant and during delivery. Some of the medications used to control myasthenia can be dangerous to a fetus in early pregnancy. I usually recommend woman to use ivig to control the disease before getting pregnant. Given the risks associated with delivery (mostly the high risk of c-section) i would recommend you visit a high risk obstetrics practice before you get pregnant.
Dr. Simon Fishman
Dr. Simon Fishman
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