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Meta-Analysis
. 2022 Feb 16;17(1):52.
doi: 10.1186/s13023-022-02205-z.

Risk factors for pregnancy-related clinical outcome in myasthenia gravis: a systemic review and meta-analysis

Manqiqige Su #  1   2 , Xiaoqing Liu #  3 , Liang Wang  1   2 , Jie Song  1   2 , Zhirui Zhou  4 , Sushan Luo  5   6 , Chongbo Zhao  7   8
Affiliations
Meta-Analysis

Risk factors for pregnancy-related clinical outcome in myasthenia gravis: a systemic review and meta-analysis

Manqiqige Su et al. Orphanet J Rare Dis. .

Abstract

Objective: Myasthenia gravis (MG) is an autoimmune disorder that frequently affects females at reproductive age. Herein, we aimed to assess the associations of clinical factors with pregnancy-related outcome in MG.

Methods: We searched PubMed and EMBASE for case-control and cohort studies that reported the MG status during or after pregnancy and relevant clinical variables. The data was extracted in proportions and odds ratios (ORs) with 95% confidence intervals (CIs) in subsequent meta-analysis.

Results: Fifteen eligible articles reporting on 734 pregnancies with 193 worsening and 51 improved episodes were included out of 1765 records. The estimated worsening proportions in total, antepartum and postpartum periods were 0.36 (95% CI 0.25-0.40), 0.23 (95% CI 0.14-0.34) and 0.11 (95% CI 0.04-0.22) respectively. The proportion of pregnancy-related improvement in enrolled patients was 0.28 (95% CI 0.17-0.40), with 0.07 (95% CI 0.00-0.28) during pregnancy and 0.14 (95% CI 0.02-0.34) after pregnancy. No significant associations were disclosed between the clinical factors and MG worsening. Thymectomy before delivery is a strong predictor for MG improvement in postpartum period (OR 4.85, 95% CI 1.88-12.50, p = 0.001).

Conclusion: The total proportion of pregnancy-related MG worsening and improvement in MG was 0.36 (95% CI 0.25-0.40) and 0.28 (95% CI 0.17-0.40), respectively. Thymectomy before the delivery may aid in clinical improvements associated with pregnancy. Future prospective cohort studies are required to determine more relevant factors.

Keywords: Meta-analysis; Myasthenia gravis; Pregnancy; Risk factor; Worsening.

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Conflict of interest statement

We declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA (The Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow chart of study selection
Fig. 2
Fig. 2
The pooled total proportions of worsening associated with pregnancy. Events: number of pregnancies with worsening associated with pregnancy. Total: total number of pregnancies
Fig. 3
Fig. 3
Forest plots of association between clinical factors and worsening of MG status in odds ratio. Ten risk factors were extracted and there was no significant difference in ORs for worsening
Fig. 4
Fig. 4
The pooled total proportions of MG improvement associated with pregnancy. Events: number of pregnancies with improved associated pregnancy. Total: total number of pregnancies
Fig. 5
Fig. 5
Forest plot of association between thymectomy during/after pregnancy and improvement of MG status. Events: number of pregnancies with improved associated pregnancy. Total: total number of pregnancies
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References

    1. Carr AS, Cardwell CR, McCarron PO, McConville J. A systematic review of population based epidemiological studies in myasthenia gravis. BMC Neurol. 2010;10:46. - PMC - PubMed
    1. Chen J, Tian DC, Zhang C, Li Z, Zhai Y, Xiu Y, et al. Incidence, mortality, and economic burden of myasthenia gravis in China: a nationwide population-based study. Lancet Reg Health West Pac. 2020;5:100063. - PMC - PubMed
    1. Grob D, Brunner N, Namba T, Pagala M. Lifetime course of myasthenia gravis. Muscle Nerve. 2008;37(2):141–149. - PubMed
    1. Andersen JB, Heldal AT, Engeland A, Gilhus NE. Myasthenia gravis epidemiology in a national cohort; combining multiple disease registries. Acta Neurol Scand Suppl. 2014;198:26–31. - PubMed
    1. Ferrero S, Pretta S, Nicoletti A, Petrera P, Ragni N. Myasthenia gravis: management issues during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2005;121(2):129–138. - PubMed

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