Impact of Pregnancy on Women With Cystic Fibrosis: 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 between 18 and 29 years of age. The index visit occurred at a mean (± SD) time of 72 ± 38 days before the first reported pregnancy visit. Baseline pulmonary function was better in women who became pregnant than in the never-pregnant comparison group (Table 1). Baseline FEV1 values covered a wide range but were unimodal. The lower and upper quartiles for FEV1 were 54% and 83% predicted, respectively, for pregnant patients, and 45% and 82% predicted, respectively, for never-pregnant patients. Thus, the difference in mean values can be attributed to there being disproportionately fewer pregnant women at the lower FEVj values. Compared to nonpregnant women, pregnant women demonstrated significantly higher FEVj (p < 0.001) and FVC (p < 0.001) values during each time period. During pregnancy, pulmonary function decreased, and this decrease persisted during the 18 months following pregnancy (Fig 3). Although this decline in FEV1 was greater in women in the pregnant than in those in the nonpregnant group ( — 6.8% vs —4.7%, respectively), the overall difference was not significant (p = 0.61). Click Here

Nutritional status, as determined by mean body weight and the percentage of the predicted ideal body weight, was better in the pregnant patients than in the nonpregnant patients (Table 1). During the baseline period, pregnant women had higher actual body weights (p = 0.01) but similar percent ideal body weights (p = 0.09) compared to the nonpregnant women. As expected, pregnant women gained a substantial amount of weight during the pregnancy and lost it following pregnancy, returning to their prepregnancy weight. During the follow-up period, women who had been pregnant demonstrated a significantly higher percent ideal body weight (p = 0.04) compared to nonpregnant women.

Figure-2

Figure 2. Age distribution of 216 pregnant CF patients who were enrolled in the ESCF.

Figure-3

Figure 3. FEV1 trends in pregnant and nonpregnant women with CF during three separate time periods (at baseline, during pregnancy, and at follow-up). Pregnant patients had higher lung function during each time period compared to nonpregnant patients (p < 0.001); however, trend lines were not different (p = 0.61).

Table 1—Percent Predicted Lung Function and Nutritional Measures in Pregnant and Nonpregnant Women With CF at Three Separate Time Periods

Variables Baseline During Pregnancy Follow-up
IPregnant Nonpregnant IPregnant Nonpregnant IPregnant Nonpregnant
FEVb % predicted 74.5 ± 1.6t 66.4 ± 0.21 69.9 ± 1.6f 63.8 ± 0.2 67.7 ± 1.7t 61.7 ± 0.2
FVC, % predicted 87.3 ± 1.5t 81.0 ± 0.2 83.3 ± 1.5t 78.6 ± 0.2 82.5 ± 1.5t 76.2 ± 0.2
Weight, kg CDС+15 51.9 ± 0.1 57.2 ± 0.6 52.5 ± 0.1 CD+ 1 1>CO5 52.6 ± 0.1
IBW, % ©+1CO 98.5 ± 0.1 107.6 ± 1.0 98.3 ± 0.1 100.6 ± 1.0| 98.5 ± 0.1
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