Impact of Pregnancy on Women With Cystic Fibrosis: Results

Impact of Pregnancy on Women With Cystic Fibrosis: ResultsDuring the baseline period, the women who later became pregnant were seen an average of 5.4 times per year for outpatient clinical care compared to 4.7 times per year for the nonpregnant cohort (p < 0.001). Clinic visits were 33% more frequent during pregnancy compared to the baseline period (7.2 vs 5.4 visits per year, respectively; p < 0.001). However, in the follow-up period, the frequency of visits decreased to levels below baseline values (p = 0.002). Women who became pregnant were also seen more frequently during pregnancy (p < 0.001) and during the follow-up period compared with control subjects (p = 0.002).
Hospitalizations for the pregnant group were minimally higher during the baseline period (p = 0.43). Hospital admissions increased by 37% during pregnancy (from 0.81 to 1.11 hospital admissions per year; p = 0.02); however, this increase did not persist during the 18 months after pregnancy. Hospitalizations for nonpregnant women increased by 11% over the same time period. The overall difference between groups was not significant (p = 0.21) (Table 2). A variety of drug therapies were administered to pregnant and nonpregnant patients (Table 3). birthcontroltab.com

In general, pregnant women received more IV and inhaled antibiotics before and during pregnancy than did nonpregnant women, while the use of oral quinolone antibiotics decreased during pregnancy. Dornase alfa use decreased during pregnancy and remained low during the follow-up period. Medical treatment for diabetes was twice as common in nonpregnant patients during the baseline period (Table 4). During pregnancy, the number of women receiving diabetes therapy more than doubled. In the follow-up period, nearly half of those patients who began treatment for diabetes during pregnancy continued to require therapy. In the nonpregnant group, the number of patients being treated for diabetes increased by 35%, compared to the 55% increase in the pregnant group between the baseline and follow-up periods. The percentage of women receiving both oral and parenteral nutritional supplements increased markedly during pregnancy and persisted following pregnancy (Table 4). There was no change in the nutritional support provided over the same time period in the nonpregnant control group.

Table 2—Annual Clinic Visits and Hospital Admissions

Baseline During Pregnancy Follow-up
Variables 1 Pregnant I Nonpregnant I Pregnant I Nonpregnant l Pregnant l Nonpregnant
Clinic visits 5.4t 4.7 7.2t 4.5 4.7J 4.1
Hospital admissions 0.81 0.75 1.1§ 0.83 0.82 0.83

Table 3—Pregnant and Nonpregnant Women With CF Receiving Respiratory Therapies During Three Separate Time Periods

Treatment Baseline During Pregnancy Follow-up
I Pregnant Nonpregnant I Pregnant Nonpregnant I Pregnant Nonpregnant
Antibiotics (RTE) 69.0 64.5 62.5 54.6 67.1 62.1
Oral quinolones 46.8 43.0 18.1 32.7 46.3 39.6
IV antibiotics 54.2 42.7 45.8 36.9 46.8 44.0
Inhaled antibiotics 31.5 28.0 29.6 19.7 23.1 24.1
Dornase alfa 56.5 59.7 39.4 54.6 35.2 50.1

Table 4—Pregnant and Nonpregnant Women With CF Receiving Other Therapies During Three Separate Time Periods

Treatment Baseline During Pregnancy Follow-up
I Pregnant I Nonpregnant I Pregnant Nonpregnant I Pregnant Nonpregnant
Oral nutritional supplements 32.4 34.4 42.1 29.8 36.1 34.8
Parenteral nutritional supplements 0.0 1.4 2.3 1.3 1.9 2.5
Insulin/oral hypoglycemic agents 9.3 18.7 20.8 20.6 14.4 25.2
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