Pregnancy in Cystic Fibrosis of the Pancreas

Grand, Richard J.

doi:10.1001/jama.1966.03100120061014

Cited by 68 publications

(30 citation statements)

References 19 publications

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“…Since the first series of pregnancies in women with cystic fibrosis was reported in 1966 7 , a number of case series have appeared from the United States 8,9 , Canada 10 and Germany 16 and, with several case reports, have been reviewed by Kent and Farquharson 17 . Our study, the largest outside the United States, details the experience in the United Kingdom and describes the outcome of pregnancy in relation to the severity of maternal disease.…”

Section: Discussionmentioning

confidence: 95%

“…In the United States approximately 140 pregnancies have been reported annually since 1991, accounting for 3%–4% each year of women aged ≥ 17 6 . Early reports of pregnancy 7–10 showed poor fetal outcomes and a deterioration in the woman's condition, especially in women with more severe disease, although recent reports suggest outcomes for the woman and her child have improved. In this study we reviewed pregnancies of women with cystic fibrosis in the UK, describing the severity of cystic fibrosis before conception, the obstetric and infant outcomes and maternal health during and after pregnancy, with a view to giving information concerning preconceptual counselling.…”

Section: Introductionmentioning

confidence: 99%

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The outcome of 72 pregnancies in 55 women with cystic fibrosis in the United Kingdom 1977–1996

Edenborough

Mackenzie

Stableforth

2000

BJOG

109

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Objective To identify pregnancies in women with cystic fibrosis and describe obstetric, infant and maternal medical outcomes in relation to the severity of maternal disease. Design Retrospective study, based on casenotes. Setting Eleven cystic fibrosis centres in the United Kingdom. Population Pregnant women with cystic fibrosis. Methods Single observer medical and obstetric casenote review categorising maternal cystic fibrosis (e.g. genotype, pancreatic, hepatic and diabetic status) and pre‐pregnant severity (e.g. weight and lung function) and noting fetal outcome and maternal morbidity. Main outcome measures Completed pregnancies and pregnancy losses, fetal outcome and complications, maternal morbidity, such as changes in weight, lung function, pulmonary infections during and after pregnancy. Relation of outcomes to severity of maternal cystic fibrosis. Results From 72 pregnancies identified, the outcomes were known for 69; there were 48 live births (70%) of which 22 were premature (46%); 14 therapeutic abortions (20%); and 7 miscarriages (10%). There were no stillbirths, neonatal or early maternal deaths. Three major fetal anomalies were seen, but no infant had cystic fibrosis. At the conclusion of our study three pregnancies were still continuing. Prematurity with increased fetal complications and maternal morbidity with infection, declining lung function and poor weight gain were associated with poor pre‐partum lung function. Conclusion Pregnancy occurs in women with cystic fibrosis of all degrees of severity. Outcomes for the infant are generally good but are variable for the mother. Predicting outcome on the basis of maternal severity is difficult but lung function appears to be the most significant determining factor. Pregnancy may be normal in women with normal lung function (forced expiratory volume > 80%). However, it may adversely affect mild and moderate lung disease due to cystic fibrosis and should be avoided in pulmonary hypertension, cor pulmonale and when forced expiratory volume < 50% predicted. Ideally, all pregnancies should be planned with prior counselling and monitored by dedicated cystic fibrosis teams, including obstetricians who are experienced in managing high risk pregnancies.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

The outcome of 72 pregnancies in 55 women with cystic fibrosis in the United Kingdom 1977–1996

Edenborough

Mackenzie

Stableforth

2000

BJOG

109

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“…She delivered a healthy premature baby but died 5 weeks postpartum from respiratory failure. Initial reports 9,10 suggested high maternal and perinatal mortality and pregnancy generally was discouraged. In the subsequent four decades, however, the prognosis of cystic fibrosis has improved and attitudes towards pregnancy have gradually changed.…”

Section: Historical Perspective On Cystic Fibrosis and Pregnancymentioning

confidence: 99%

“…Approximately 30–40 women with cystic fibrosis undertake pregnancy each year in the UK 12 . Early reports 9,13 suggested that pregnancy was associated with high rates of miscarriage, premature delivery and stillbirth. Recent data, however, demonstrate good fetal outcomes (Table 1).…”

Section: The Effects Of Cystic Fibrosis On Pregnancymentioning

confidence: 99%

Cystic fibrosis and pregnancy

Goddard¹,

Bourke

2009

The Obstetric & Gynaecologis

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Cystic fibrosis is the most common inherited life‐threatening disease. Advances in treatment have led to increased life expectancy. Increasing numbers of women with cystic fibrosis are choosing to embark on pregnancy; for most, it does not appear to have a detrimental effect on long‐term health. Pregnancy outcomes are generally good but 20% of women do not live to see their child's tenth birthday. Learning objectives: To be aware of the effects of cystic fibrosis on pregnancy. To understand the importance of preconceptual counselling. To appreciate that pregnancy management requires a multidisciplinary approach. Ethical issues: Should doctors advise women with cystic fibrosis and poor lung function against undertaking pregnancy? Should assisted reproductive technology be available for women with life‐limiting diseases? Please cite this article as: Goddard J, Bourke SJ. Cystic fibrosis and pregnancy. The Obstetrician & Gynaecologist 2009;11:19–24.

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“…Pregnancy in a woman with CF was first described in 1960 (25) and a series reviewed in 1966 (26). Subsequent series have been published from the USA (27,28), Canada (29,30), the UK (31,32), Germany (33), and now, in the second paper in this journal, Scandinavia (34).…”

mentioning

confidence: 99%

Pregnancy in women with cystic fibrosis

Edenborough

2002

Acta Obstet Gynecol Scand

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Pregnancy in Cystic Fibrosis of the Pancreas

Cited by 68 publications

References 19 publications

The outcome of 72 pregnancies in 55 women with cystic fibrosis in the United Kingdom 1977–1996

The outcome of 72 pregnancies in 55 women with cystic fibrosis in the United Kingdom 1977–1996

Cystic fibrosis and pregnancy

Pregnancy in women with cystic fibrosis

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