Favorable Pregnancies With Cystic Fibrosis

Cystic fibrosis does not have to prevent women from having successful pregnancies

(RxWiki News) Although women with cystic fibrosis typically have lung problems, they can give birth to healthy children without causing significant damage to their lungs.

Medical advances have led to a much improved quality of life and life expectancy for people with cystic fibrosis—a common inherited disease among Caucasians.

A recent study found that women with the disease can have successful pregnancies without apparent major deterioration of their lung function. They may, however, have a higher likelihood of preterm delivery and cesarean section, or c-section.

"Talk to your Ob/Gyn about complications."

J.G. Thorpe-Beeston, MD, in the Department Obstetrics and Gynaecology, Chelsea and Westminster NHS Foundation Trust in London, and collaborators looked at the outcomes of 48 pregnancies in 41 women with cystic fibrosis.

While two pregnancies in this study resulted in miscarriages, 46 pregnancies continued beyond the first trimester with no fetal losses.

Cystic fibrosis is caused by a mistake in a protein that maintains the chloride (salt) balance in the body. The mistake causes it to produce a thick, sticky mucus that can cause breathing problems and lung infections, digestive complications (difficulty absorbing some foods) and, in some cases, infertility. In addition to lung function, the condition can affect cardiac and pancreatic function.

Investigators found that pregnant women with cystic fibrosis did not appear to suffer long-term loss of lung function. During the course of their pregnancy, however, they required more hospital visits, suffered more respiratory problems, and experienced other health issues.

This study supported previous research by the North American CF Foundation. That paper concluded that survival of pregnant women with even very poor lung function was not worse and, indeed, may have been improved compared with a non-pregnant matched population.

Women with cystic fibrosis may have poor lung function, measured by forced expiratory volume (FEV1). FEV1 is the maximum amount of air you can forcefully exhale in one second. Patients with FEV1 equal to or less than 60 percent were more likely to deliver earlier and by c-section (surgery) than those with FEV1 greater than 60 percent.  FEV1 of 80 percent or more is considered normal.

Just under half of the babies were delivered prematurely (delivered before 37 weeks), and they all had positive outcomes. Cystic fibrosis does not cause mental retardation or birth defects.

Three women with the worst pre-pregnancy lung function gave birth to infants who died within 18 months of delivery.

“Modern obstetric [relating to childbirth] and cystic fibrosis management, together with expert neonatal [relating to the newborn] and anesthetic services, have combined to enable women with CF to have successful pregnancies without apparent significant deterioration of their lung function,” said the authors. “Pre-existing lung function will determine to a great degree the time some women may spend as parents.”

Survival rates for people with the disease have increased over the decades. The American Lung Association reports that the median survival age was about 25 years in 1985. Today, many people with the disease can now expect to live into their 30s, 40s and beyond, according to the Cystic Fibrosis Foundation.

The study was published online in November in BJOG: An International Journal of Obstetrics and Gynaecology.

Review Date: 
January 27, 2013