Survival of patients with cystic fibrosis (CF) has improved dramatically over the last 30 years. Affected women now survive to reproductive age, but what impact does pregnancy have on their health and this chronic disease on fetal outcome?
Method Retrospective analysis of pregnancies in patients with CF over the 5-year period 2005–2009.
Results 15 patients identified: three had CF related diabetes mellitus and two gestational diabetes. 13 conceived spontaneously, one had invitrofertilisation (IVF) and one preimplantation genetic diagnosis (PGD). Only 6/15 (40%) received preconception counselling and 9/15 (60%) pregnancies were unplanned.
Mean Gestation at Delivery 36 weeks+5 days, 46% delivering vaginally, 64% via elective Caesarean section (five for obstetric indications, one for deteriorating lung function). Birth weights: mean 2.7 kg (range 1.95–3.67 kg).
Mean maternal weight gain during pregnancy was 6.7 kg (range −0.5 to +13.6 kg). Food supplements were required in 11/15 (73%). By 6-month post delivery 7/15 (47%) had lost weight compared to prepregnancy levels, (mean decrease 5.6 kg).
14/15 (93%) had stable lung function throughout pregnancy, two of which had a significant (p<0.05) decrease forced expiratory volume in one second (FEV1) by 6 months postnatal. Women with prepregnancy FEV1 <50% delivered babies with significantly lower (p<0.05) birth weights.
Conclusion With multidisciplinary care, the outcome for the majority of women with CF embarking on pregnancy is good. However, more education is required to optimise preconception health (especially lung function) and intensify postnatal support and follow-up to prevent the deterioration of lung function and weight loss seen in this study.
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