A retrospective study describes eight pregnancies in six women with severe SMA, who were all wheelchair-dependent, including one case of type I SMA.
- The three women who were receiving noninvasive ventilation (NIV) at home prior to their pregnancies experienced a deterioration in their respiratory function. They required increased respiratory support but were able to return to their pre-pregnancy parameters within a month of giving birth.
- All women gave birth by scheduled cesarean section under general anesthesia, as local anesthesia was often technically impossible due to the presence of spinal metal rods or severe scoliosis.
- Although six infants were born prematurely and four required admission to intensive care, there were no neonatal deaths or congenital malformations.
- None of the women became pregnant during background treatment, so this study does not provide any new information on their use during pregnancy and their impact on the fetus.
Favorable outcomes for both mother and child are achievable, even in severe phenotypes, thanks to a multidisciplinary team (obstetricians, anesthesiologists, and pulmonologists), which should in future include neurologists to manage new innovative treatments.
