Women With CMT Risk Childbirth
Complications
Charcot-Marie-Tooth (CMT)
disease, a disorder of nerve fibers that connect the
spinal cord with the rest of the body, is a factor for complications
during pregnancy and delivery, says a large study conducted
in Norway between 1967 and 2002 and published recently in Neurology.
Jana Hoff and colleagues at the University of Bergen reviewed
the records of 108 births by mothers with CMT and compared them
to a reference group of 2.1 million births by women without
CMT.
In the CMT-affected group, the rate of abnormal positioning
of the baby was 9.3 percent, compared to 4.5 percent in the
unaffected women. Bleeding after delivery occurred in 12 percent
of the CMT-affected women, compared with 5.8 percent of the
women without CMT.
Women with CMT delivered their babies by Caesarean or with
the aid of forceps or a vacuum device 29.6 percent of the time,
while women without CMT underwent these procedures 15.3 percent
of the time. The majority of CMT Caesarean operations were emergencies,
and forceps were used three times as often in the CMT group
as in the non-CMT group.
The researchers speculate that causes of these differences
could include the presence of CMT-related weakness in the baby
and lack of muscle tone in the mother’s uterus.
“CMT has up till now been acknowledged as a disease mainly
affecting distal [far from the body’s center] extremities
with no significant effect on pregnancy, delivery and the newborn,”
the authors write. “The results from our study question
this view and show that maternal CMT should be considered a
potential risk factor during delivery.”
Similar results were recently reported with respect to delivery
complications in women with myasthenia
gravis (see “Pregnancy
in MG,” Quest March-April 2004).
