Chest
Volume 129, Issue 3, March 2006, Pages 706-711
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Original Research: CYSTIC FIBROSIS
Impact of Pregnancy on Women With Cystic Fibrosis

https://doi.org/10.1378/chest.129.3.706Get rights and content

Background:

Improvements in the health and survival of patients with cystic fibrosis (CF) have led to increasingly normal lifestyles, including successful pregnancies in women with CF. Concern exists among care providers about the impact of pregnancy on the health of women with CF.

Study objectives:

We examined data from a large longitudinal observational study, the Epidemiologic Study of Cystic Fibrosis (ESCF), to characterize health outcomes and CF-related therapies in women who became pregnant.

Design:

This analysis was conducted using ESCF data from 1995 to 2003.

Patients:

A total of 216 women, aged 15 to 38 years, who met the criteria for a qualifying pregnancy, were compared with a matched group of never-pregnant women during three time periods (ie, baseline, during pregnancy, and follow-up).

Interventions:

None.

Results:

The baseline pulmonary function (FEV1) values were 74.5% and 66.4% predicted, respectively, in the pregnant and nonpregnant women. Declines in FEV1 values of 6.8% and 4.7%, respectively, were observed from baseline to follow-up in the pregnant and nonpregnant women (p = 0.61). During pregnancy, outpatient visits were 33% more frequent compared to baseline and 62% more frequent than in the nonpregnant group (7.19 vs 4.45, respectively, visits annually). Annual rates of respiratory exacerbation and hospitalization were similar at baseline but increased during pregnancy. The prevalence of treatment for diabetes more than doubled, from 9.3% at baseline to 20.6% during pregnancy, and was 14.4% at follow-up. In contrast, 18.7% of the never-pregnant women were being treated for diabetes at baseline, rising to 25.2% at follow-up.

Conclusions:

These findings suggest that, over the same time period, women with CF who become pregnant experienced similar respiratory and health trends as nonpregnant women. However, pregnant women use a greater number of therapies and receive more intense monitoring of their health. These findings have implications for clinicians providing prepregnancy counseling for women with CF.

Section snippets

Materials and Methods

We examined data from the ESCF that documented the clinical course and treatment of 24,000 individuals with CF living in the United States and Canada who were followed up for up to 9 years. Sites providing care for ≥ 10 patients with a documented diagnosis of CF who elected to participate obtained patient consent, as required by local investigational review boards, and collected data, including those on specific pulmonary and nutritional therapies for each patient encounter. All patient therapy

Results

A total of 216 women aged 15 to 38 years met the criteria for at least one qualifying pregnancy reported during the 9 years of the study (Fig 2). Single pregnancies occurred in 192 women (89%). The remaining 24 pregnancies included in this analysis represented multiple pregnancies (first pregnancy, 15 pregnancies; second pregnancy, 8 pregnancies; or third pregnancy, 1 pregnancy). The median age at the time of pregnancy was 24 years; three fourths of pregnancies occurred in women who were

Discussion

Because of improved health outcomes in patients with CF, an increasing number of affected women are interested in bearing children. Investigators have previously reported5, 6, 7, 89 that the outcomes associated with these pregnancies include healthy infants, a slight deterioration in maternal pulmonary function, and uncompromised long-term survival. Our findings are consistent with these reports and, in addition, show a substantial increase in therapy both during and after the pregnancy in

Conclusions

Analyses of data from this large cohort demonstrate that women with CF can experience a pregnancy with the impact on their overall respiratory and nutritional health being similar to nonpregnant women. Pregnant women with CF will likely require increased use of various therapies and more hospitalizations, and receive more intensive monitoring of their health. In addition, these women will have an increased chance of requiring treatment for diabetes both during and after pregnancy. There is also

References (17)

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Cited by (86)

  • Pregnancy in cystic fibrosis: Review of the literature and expert recommendations

    2022, Journal of Cystic Fibrosis
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    As in the CF registry study by Goss et al., women who became pregnant had higher baseline lung function than those who did not become pregnant [50]. Given that the use of IV antibiotics did not increase during the same period, the authors believed pregnant women were being admitted more frequently for closer surveillance or for potential obstetric complications [47]. We, therefore, recommend that clinicians discuss the potential increase in clinic visits and antibiotics use that may occur during pregnancy as women are planning their pregnancies.

  • Gestational and pregestational diabetes in pregnant women with cystic fibrosis

    2022, Journal of Clinical and Translational Endocrinology
  • Challenges Faced by Women with Cystic Fibrosis

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