Impact of pregnancy on women with cystic fibrosis.
BACKGROUND
Improvements in the health and survival of patients with cystic fibrosis (CF) have led to increasingly normal lifestyles, including successful pregnancies in women with CF. Concern exists among care providers about the impact of pregnancy on the health of women with CF.


OBJECTIVE
We examined data from a large longitudinal observational study, the Epidemiologic Study of Cystic Fibrosis (ESCF), to characterize health outcomes and CF-related therapies in women who became pregnant.


METHODS
This analysis was conducted using ESCF data from 1995 to 2003.


METHODS
A total of 216 women, aged 15 to 38 years, who met the criteria for a qualifying pregnancy, were compared with a matched group of never-pregnant women during three time periods (ie, baseline, during pregnancy, and follow-up).


METHODS
None.


RESULTS
The baseline pulmonary function (FEV(1)) values were 74.5% and 66.4% predicted, respectively, in the pregnant and nonpregnant women. Declines in FEV(1) values of 6.8% and 4.7%, respectively, were observed from baseline to follow-up in the pregnant and nonpregnant women (p = 0.61). During pregnancy, outpatient visits were 33% more frequent compared to baseline and 62% more frequent than in the nonpregnant group (7.19 vs 4.45, respectively, visits annually). Annual rates of respiratory exacerbation and hospitalization were similar at baseline but increased during pregnancy. The prevalence of treatment for diabetes more than doubled, from 9.3% at baseline to 20.6% during pregnancy, and was 14.4% at follow-up. In contrast, 18.7% of the never-pregnant women were being treated for diabetes at baseline, rising to 25.2% at follow-up.


CONCLUSIONS
These findings suggest that, over the same time period, women with CF who become pregnant experienced similar respiratory and health trends as nonpregnant women. However, pregnant women use a greater number of therapies and receive more intense monitoring of their health. These findings have implications for clinicians providing prepregnancy counseling for women with CF.
McMullen
Ann H
AH
University of Rochester School of Nursing, 601 Elmwood Avenue, Rochester, NY 14642, USA. ann_mcmullen@urmc.rochester.edu
Pasta
David J
DJ
Frederick
Paul D
PD
Konstan
Michael W
MW
Morgan
Wayne J
WJ
Schechter
Michael S
MS
Wagener
Jeffrey S
JS
D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006801:Humans; D009752:Nutritional Status; D011247:Pregnancy; D011256:Pregnancy Outcome