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Transient neonatal myasthenia gravis: refining risk estimate for infants born to women with myasthenia gravis

Journal of Perinatology volume 41, pages 2279–2283 (2021)Cite this article

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Abstract

Objective

Transient neonatal myasthenia gravis (TNMG) can render a neonate vulnerable to catastrophic respiratory depression. Our aim was to describe the clinical manifestations of TNMG, and to determine when the myasthenic signs become apparent in TNMG.

Methods

We reviewed our own experience of infants who underwent routine inpatient monitoring for TNMG and combined our local data with observations from previous studies.

Results

Only three case series (n = 110) reported both the type and timing of onset of myasthenic signs. Adding local data (n = 37) yielded 147 infants born to women with MG. Fifteen infants (10%) developed signs of TNMG with onset being 1.5 ± 2.6 days (mean ± 3SD) after birth. Feeding difficulties and low tone were the commonest presenting signs, and only 1 of the 147 infants needed intubation for hypoventilation.

Conclusions

TNMG signs were mostly not life-threatening. We suggest only 4 days of routine postnatal observation for infants born to women with MG.

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Acknowledgements

Rachael A. Pace from the Department of Pediatrics at the University of Michigan helped with Electronic Medical Record Search Engine to identify the study population.

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Authors and Affiliations

  1. Department of Pediatrics, Neonatal-Perinatal Medicine, University of Michigan Health System, Ann Arbor, MI, USA

    Paramjeet K. Kochhar, Robert E. Schumacher & Subrata Sarkar

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  1. Paramjeet K. Kochhar
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  2. Robert E. Schumacher
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  3. Subrata Sarkar
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Contributions

SS developed the study concept and design, and analyzed the data. He also collected data and critically revised and approved the final manuscript. PK collected data and she received input from the other authors while writing the manuscript. RES provided critical input into the design, and approved the final manuscript.

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Correspondence to Subrata Sarkar.

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Kochhar, P.K., Schumacher, R.E. & Sarkar, S. Transient neonatal myasthenia gravis: refining risk estimate for infants born to women with myasthenia gravis. J Perinatol 41, 2279–2283 (2021). https://doi.org/10.1038/s41372-021-00970-6

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