Pregnancy Outcome in Patients with Common Variable Immunodeficiency.
OBJECTIVE
The aim of our retrospective study was to clarify fertility, pregnancy complications and outcomes in common variable immunodeficiency (CVID) females.


METHODS
Retrospective data were obtained from three Czech referral centres. The data were compared with data obtained from the Czech National Registry of Reproduction Health.


RESULTS
Our cohort of patients comprised 54 women with 115 pregnancies; 88 pregnancies in 50 females were finished with live births (77 %). In only 8 women (15%) was the diagnosis of CVID established before the first pregnancy. Replacement immunoglobulin therapy was performed in 10 patients without any moderate or severe adverse effects. Compared with the Czech population, the CVID patients suffered significantly more frequently from the threat of preterm labour (p < 0.0001), vaginal bleeding (p = 0.0001), eclampsia/preeclampsia (p = 0.009) and a higher number of stillbirths (p < 0.0001). Furthermore, the frequency of babies with low birth weight (less than 2500 g) born to the CVID patients was increased compared with the normal population (p < 0.0001). Serum IgG, IgA and IgM determination was done in 57 children of 50 mothers showing 13 cases of IgA deficiency (23%). There was no significant difference among the non-symptomatic, symptomatic untreated and symptomatic treated females in any of the determined gynaecological complications. The number of unsuccessful pregnancies was higher in the symptomatic untreated women.


CONCLUSIONS
Fertility in CVID patients is not decreased, and their pregnancies could be considered more risky compared with those of the general population.
Institute of Clinical Immunology and Allergology, University Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic.
Pavlina
P
Kralickova
Reprofit International, s.r.o., Hlinky 122/48, 60300, Brno, Czech Republic.
Barbora
B
Kurecova
Institute of Clinical Immunology and Allergology, University Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic.
Ctirad
C
Andrys
Institute of Clinical Immunology and Allergology, University Hospital, Sokolska 581, 50005, Hradec Kralove, Czech Republic.
Irena
I
Krcmova
Centre of Immunology and Microbiology, Regional Institute of Public Health, P.O. BOX 115, 40002, Usti nad Labem, Czech Republic.
Dalibor
D
Jilek
Departmant of Clinical Immunology and Allergology, St. Anne's University Hospital, Pekařská 53, 65691, Brno, Czech Republic.|Department of Clinical Immunology and Allergology, Faculty of Medicine, Masaryk University, Pekarska 53, 65691, Brno, Czech Republic.
Marcela
M
Vlkova
Departmant of Clinical Immunology and Allergology, St. Anne's University Hospital, Pekařská 53, 65691, Brno, Czech Republic. jiri.litzman@fnusa.cz.|Department of Clinical Immunology and Allergology, Faculty of Medicine, Masaryk University, Pekarska 53, 65691, Brno, Czech Republic. jiri.litzman@fnusa.cz.
Jiri
J
Litzman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017074:Common Variable Immunodeficiency / Q000150:complications / Q000276:immunology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000235:genetics; D008875:Middle Aged; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy / Q000276:immunology*; D011248:Pregnancy Complications / Q000276:immunology*; D011256:Pregnancy Outcome; D014592:Uterine Hemorrhage / Q000209:etiology; D055815:Young Adult
D007070:Immunoglobulin A
CVID; fertility; pregnancy; replacement therapy