title: Pregnancy outcomes in the current era of cystic fibrosis care: a 15-year experience.
abstract: BACKGROUND
  With improvement in clinical care and longer survival of patients with cystic fibrosis (CF), pregnancy has become commonplace. However, the impact of pregnancy on maternal health and fetal outcomes requires ongoing review.
  
  
  METHODS
  A retrospective study of 20 pregnancies from 18 women with CF during the period 1995-2009 was performed. Changes in lung function, body mass index (BMI) and development of gestational diabetes were recorded. Fetal outcomes and maternal survival were examined, and the influence of pre-pregnancy parameters on outcomes was evaluated.
  
  
  RESULTS
  Mean maternal age at pregnancy was 29±5 years with a mean pre-pregnancy forced expiratory volume in 1 s (FEV1) of 65.6±20.8% predicted. Eleven of 20 pregnancies had a pre-pregnancy FEV1 <60% predicted. During pregnancy, FEV1% predicted fell by 4.8% (CI 1.6-7.9), but recovered to baseline within 6 months post-partum. Mothers gained a mean weight of 7.6±3.2 kg, and gestational diabetes developed in 43% of women. All women delivered live births apart from one therapeutic abortion. Five infants were preterm, and two mature infants had low birth weight. Three mothers either died or required lung transplantation after pregnancy (range 2.5-8.0 years). FEV1 <60% predicted and BMI <20 kg/m(2) were significant predictors of fetal complications.
  
  
  CONCLUSIONS
  Most women tolerated pregnancy well without major complications despite many having at least moderate lung function impairment. Pre-pregnancy FEV1 and BMI were important predictors of outcomes.
authors.affiliation: Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia.
authors.forename: Edmund M T
authors.initials: EM
authors.lastname: Lau
authors.forename: David J
authors.initials: DJ
authors.lastname: Barnes
authors.forename: Carmel
authors.initials: C
authors.lastname: Moriarty
authors.forename: Robert
authors.initials: R
authors.lastname: Ogle
authors.forename: Ruth
authors.initials: R
authors.lastname: Dentice
authors.forename: Jane
authors.initials: J
authors.lastname: Civitico
authors.forename: Aurora
authors.initials: A
authors.lastname: Avedello
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Torzillo
authors.forename: Peter T
authors.initials: PT
authors.lastname: Bye
mesh_terms: D015992:Body Mass Index; D003550:Cystic Fibrosis / Q000150:complications / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000453:epidemiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008168:Lung / Q000502:physiology; D016040:Lung Transplantation / Q000706:statistics & numerical data; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies