Pregnancy outcomes in cystic fibrosis: a 10-year experience from a UK centre

Renton, Mandy; Priestley, L; R., Bennett, Lindsey; Mackillop, Lucy; Chapman, SJ

doi:10.1177/1753495x15575628

Cited by 17 publications

(15 citation statements)

References 28 publications

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“…The mean age at delivery was 28 years. Similar mean age of between 27 and 30 years is reported by the cases in the most recent reports 5,10,11,13,18,19 and shows an increase compared with those studies including cases from the 1970s 20,21 …”

Section: Discussionsupporting

confidence: 85%

The outcome of pregnancy in women with cystic fibrosis: a UK population‐based descriptive study

Ashcroft

Chapman

Mackillop

2020

BJOG

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Objective To estimate the incidence of cystic fibrosis in pregnancy and to explore obstetric and neonatal outcomes. Design A population‐based descriptive study using the methodology of the UK Obstetric Surveillance System (UKOSS). Setting All consultant‐led maternity units in the UK. Population All pregnant women with a diagnosis of cystic fibrosis who booked for antenatal care in a UK obstetric unit between March 2015 and February 2017. Methods Prospective case collection identified using UKOSS monthly notification. Main outcome measures Incidence, maternal morbidity, maternal mortality, gestation at delivery, neonatal mortality, neonatal morbidity. Results We report 71 pregnancies over a 2‐year period. There was one early miscarriage, four terminations and three sets of twins, resulting in the live birth of 69 infants. There were no maternal deaths. One infant died following spontaneous preterm birth at 29 weeks’ gestation. The mean gestation at delivery was 36.2 completed weeks. The mean birthweight centile for gestational age was the 61st centile. We report a positive correlation between both maternal lung function (FEV1) and mean gestation at delivery, and between FEV1 and mean birthweight centile for gestational age. Conclusions Pregnancy outcomes are generally good in women with cystic fibrosis. Successful pregnancy is possible even in those women with FEV1 <60% predicted, although such women have higher chance of preterm delivery and a smaller baby. Tweetable abstract Pregnant women with cystic fibrosis who have poorer lung function at the beginning of pregnancy have a higher risk of having a premature or smaller baby.

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Section: Discussionsupporting

confidence: 85%

The outcome of pregnancy in women with cystic fibrosis: a UK population‐based descriptive study

Ashcroft

Chapman

Mackillop

2020

BJOG

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“…Moreover data on pregnancy in CF women are unfortunately not collected by the European CF Patients' Registry as well. Information on pregnancies in European CF women is reported only on a center's basis [18,20,[22][23][24] o by the national French registry surveys [12].…”

Section: Discussionmentioning

confidence: 99%

A case-control study on pregnancy in Italian Cystic Fibrosis women. Data from the Italian Registry

Giordani¹,

Quattrucci

Amato³

et al. 2018

Respiratory Medicine

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Background: Pregnancy in CF women is no longer an exceptional event, but few information on its effect on clinical status in European CF patients are available. This study describes Italian CF pregnant population, to investigate its effect on CF woman. Methods: Data were collected (2010-2015) by the Italian CF Registry. A case-control study was performed between pregnant and never pregnant women. Results: A total of 81 pregnant women (aged 18-45ys) were identified with a mean age at pregnancy of 31ys. Median age at diagnosis resulted higher in cases (P = 0.010). A decline from 6 to 12 months before pregnancy to one year after delivery in BMI (P = 0.034), in FEV 1 (P < 0.001) and FVC (P < 0.001) was registered among cases. Difference in change between cases and controls was found for the BMI (P = 0.006); weak evidence of difference in FEV 1 (p = 0.080) and FVC (p = 0.056) were noted between the groups. Conclusion: Data from ICFR show that CF women can become mother with only slight adverse effect on their nutritional status. Further study should be carried out to investigate long term effect of pregnancy on lung function.

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“…They also demonstrated a correlation between serum levels of oestradiol and the frequency of infectious pulmonary exacerbations where the majority of events occurred during the follicular phase (high oestrogen, low progesterone) [ 49 ]. Furthermore, registry data collected during pregnancy, a period of time where oestrogen and progesterone are both heightened ( table 2 ), suggest that annual rates of pulmonary exacerbations [ 58 ] and haemoptysis [ 59 ] are higher compared to non-pregnant female controls. However, it should be noted that the increased rates of exacerbations found during pregnancy might simply be a reflection of increased frequency and intensity of monitoring or other non-hormone related physiological changes in pregnancy (such as increased acid reflux) that heighten the risk of pulmonary complications.…”

Section: Effects Of Female Sex Hormones On Pulmonary Outcomesmentioning

confidence: 99%

Sex disparities in cystic fibrosis: review on the effect of female sex hormones on lung pathophysiology and outcomes

et al. 2020

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Sex differences in morbidity and mortality have been reported in the cystic fibrosis (CF) population worldwide. However, it is unclear why CF women have worse clinical outcomes than men. In this review, we focus on the influence of female sex hormones on CF pulmonary outcomes and summarise data from in vitro and in vivo experiments on how estrogen and progesterone might modify mucociliary clearance, immunity and infection in the CF airways. The potential for novel sex hormone related therapeutic interventions is also discussed.

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Pregnancy outcomes in cystic fibrosis: a 10-year experience from a UK centre

Abstract: Consistent with current guidance we found pregnancy is feasible and well tolerated in the majority of patients with cystic fibrosis. There was a high incidence of haemoptysis, which warrants further study.

Cited by 17 publications

References 28 publications

The outcome of pregnancy in women with cystic fibrosis: a UK population‐based descriptive study

The outcome of pregnancy in women with cystic fibrosis: a UK population‐based descriptive study

A case-control study on pregnancy in Italian Cystic Fibrosis women. Data from the Italian Registry

Sex disparities in cystic fibrosis: review on the effect of female sex hormones on lung pathophysiology and outcomes

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