Effect of Maternal Cystic Fibrosis Genotype on Diabetes in Pregnancy

Abstract

Women with CF who are homozygous for the ΔF508 mutation have an increased risk of having a pregnancy complicated by diabetes.

ISPAD Clinical Practice Consensus Guidelines 2018: Management of cystic fibrosis-related diabetes in children and adolescents

“…During pregnancy, diabetes poses a risk for both the mother and fetus. Gestational diabetes develops early in pregnancy in CF . OGTT screening for preexisting diabetes should be done before or immediately after the onset of pregnancy, and screening for gestational diabetes is recommended at the end of both the first and second trimesters…”

“…Gestational diabetes develops early in pregnancy in CF. 8,75 OGTT screening for preexisting diabetes should be done before or immediately after the onset of pregnancy, and screening for gestational diabetes is recommended at the end of both the first and second trimesters. 1 There is emerging evidence that mid-OGTT glucose levels may be even more predictive of clinical decline than the 2 hour level, and thus consideration should be given to measuring glucose levels every half hour during the 2-hour test.…”

Pregnancy intention among women with cystic fibrosis : a theory of planned behavior model

“…The physical effects of pregnancy have a reciprocal and interrelated relationship with the psychosocial domain of women with CF. Furthermore, general statements about pregnancy's impact on women with CF may be difficult to apply since the genotype may affect the degree of disease severity and different genotypes have been linked to different pregnancy outcomes (Giacobbe et al, 2012). However, within the limited literature, some information has emerged regarding pregnancy among women with CF.…”

“…Caution must be taken in the presentation of generalized statements about the impact of pregnancy on women with CF, as genotype may affect the severity of disease and tolerance to pregnancy. Giacobbe et al (2012) report that women with two copies of the Delta F508 mutation have an increased risk of pregnancy complicated by diabetes compared to women with only one copy.…”

“…For example, women with CF attend more outpatient appointments, have more frequent exacerbations requiring inpatient care and require more pharmacological interventions (McMullen et al, 2006). The treatment needs of women with CF who have CFRD increase during pregnancy, and women without CFRD may develop pancreatic insufficiency during pregnancy (Giacobbe et al, 2012;McMullen et al, 2006).…”