Pregnancy in Charcot-Marie-Tooth disease: Data from the Italian CMT national registry

Objective: To collect information on frequency of pregnancy and delivery complications in Charcot-Marie-Tooth (CMT) and on CMT course during pregnancy. Methods: Through an ad hoc online questionnaire, we investigated pregnancy and neuropathy course in CMT women adhering to the Italian CMT Registry. Data were compared to controls (recruited among friends and unaffected relatives) and the Italian (or other reference) population. Results: We collected data on 193 pregnancies from 86 CMT women (aged 20-73 years), with 157 deliveries (81.4%) after a mean of 38.6 gestational weeks. In CMT women there were no differences with controls (59 pregnancies and 46 deliveries from 24 controls) and the reference population for: miscarriages (11.4%), planned (21.0%) and emergency (14.0%) cesarean sections. We found a significantly higher frequency of placenta previa (1.6% vs 0.4%), abnormal fetal presentations (8.4% vs 4.5%), and preterm deliveries (20.3% vs 6.9%; most in the 34-36 week of gestation range) as compared to reference populations. Excluding twins, newborn weight did not differ from the reference population. Post-partum bleeding rate in CMT patients (2.1%) was similar to the general population (2.4%). CMT status worsened during 18/193 pregnancies (9.3%) with no recovery in 16 of them and similar figures in CMT1A as compared to non-CMT1A subtypes. Conclusions: We observed higher rates of placenta previa, abnormal presentations, and preterm deliveries in CMT, but pregnancy outcome and newborn weight and health were similar to the reference populations. Worsening of CMT is not infrequent and occurs not only in CMT1A. Pregnant CMT women should be monitored with particular care.