Myasthenia Gravis and Pregnancy: Clinical Management and Maternal–Neonatal Outcomes

Background and Objectives: To summarize current evidence regarding the pathophysiology, clinical management, and maternal and neonatal outcomes associated with pregnancy in women with myasthenia gravis (MG). Materials and Methods: This structured narrative review was based on literature searches conducted in major biomedical databases, including PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. Eligible publications included observational studies, cohort studies, case series, and clinically relevant case reports addressing MG management during pregnancy and postpartum. Due to heterogeneity in study design, patient populations, interventions, and reported outcomes, findings were synthesized narratively rather than quantitatively. Results: The available evidence suggests that pregnancy outcomes in women with MG are generally favorable when multidisciplinary monitoring and individualized treatment strategies are applied. Disease exacerbations may occur during pregnancy or the postpartum period, particularly in women with generalized MG or respiratory involvement. Observational evidence indicates that prior thymectomy may be associated with reduced rates of MG exacerbation and transient neonatal myasthenia gravis (TNMG), although available data remain limited. Careful selection of pharmacological therapy, prenatal monitoring, anesthetic management, and postpartum surveillance is essential to optimize maternal and neonatal outcomes. Conclusions: Myasthenia gravis is generally compatible with successful pregnancy outcomes; however, affected women may require closer monitoring because of the potential risk of disease exacerbation, myasthenic crisis, and neonatal complications. Management should be individualized and supported by multidisciplinary collaboration involving neurologists, obstetricians, anesthesiologists, and neonatologists.