PREGNANCY IN MUSCULAR DYSTROPHIES: A NARRATIVE REVIEW OF CLINICAL RISKS, PHYSICAL ACTIVITY, AND MATERNAL-FETAL OUTCOMES

Abstract

Introduction and purpose: Muscular dystrophies are progressive, hereditary muscle disorders whose inheritance pattern and multisystem involvement complicate reproductive decisions, yet evidence on maternal and neonatal outcomes remains fragmented. This review summarises current literature on pregnancy in women with dystrophinopathies, myotonic dystrophy, FSHD, and LGMD, including the role of physical activity and rehabilitation. Materials and methods: Literature was retrieved from PubMed, Scopus, and Google Scholar (January–June 2025), supplemented by reference list screening, and analysed narratively by subtype. Review findings: Pregnancy in muscular dystrophy carries elevated but increasingly manageable risk depending on subtype. DM1 is linked to adverse neonatal outcomes via congenital myotonic dystrophy; dystrophinopathy carriers face cardiomyopathy and heart failure risk; FSHD and LGMD show increased instrumental delivery, falls, and weakness, supporting a role for individualised physiotherapy and respiratory training. Conclusions: Reproductive care in muscular dystrophy benefits from a multidisciplinary approach with cardiac and respiratory monitoring, anaesthetic planning, genetic counselling, and rehabilitation support, though evidence remains limited to case reports and small cohorts.