Cystic fibrosis and pregnancy in the modern era: A case control study

Ahluwalia, Monica; Hoag, Jeffrey B.; Hadeh, Anas; Ferrin, Marianne; Hadjiliadis, Denis

doi:10.1016/j.jcf.2013.08.004

Cited by 37 publications

(38 citation statements)

References 15 publications

(16 reference statements)

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“…The rare cases of maternal deaths that have been reported during pregnancy are consistent with the findings of this report, which used a much larger population [14,20,29]. Case-control studies of pregnant women with CF matched with non-pregnant CF women have found no difference in BMI or in respiratory function both intra-and post-partum [17,20,23,24]. These results suggest that, over the same time period, pregnant women with CF had the same respiratory and overall health parameters as non-pregnant CF women.…”

Section: Discussionsupporting

confidence: 88%

Maternal and perinatal outcomes of pregnancies in women with cystic fibrosis – A single centre case-control study

Girault

Blanc

Gayet

et al. 2016

Respiratory Medicine

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Section: Discussionsupporting

confidence: 88%

Maternal and perinatal outcomes of pregnancies in women with cystic fibrosis – A single centre case-control study

Girault

Blanc

Gayet

et al. 2016

Respiratory Medicine

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“…Similar results have been demonstrated in other recent studies, with women who became pregnant experiencing similar respiratory and health trends as those who did not, although in some reports their utilization of health resources was greater. [32][33][34] Whether or not pregnancy impacts on the trajectory of progression of lung disease for patients with CF, there are physical and emotional demands of child rearing that have the potential to reduce any individual parent's ability to adhere to maintenance therapies themselves. This may lead to a deterioration in their own health.…”

Section: Impact Of Cf On Maternal Outcomesmentioning

confidence: 99%

Pregnancy and cystic fibrosis: Approach to contemporary management

et al. 2014

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Over the previous 50 years survival of patients with cystic fibrosis has progressively increased. As a result of improvements in health care, increasing numbers of patients with cystic fibrosis are now considering starting families of their own. For the health care professionals who look after these patients, the assessment of the potential risks, and the process of guiding prospective parents through pregnancy and beyond can be both challenging and rewarding. To facilitate appropriate discussions about pregnancy, health care workers must have a detailed understanding of the various important issues that will ultimately need to be considered for any patient with cystic fibrosis considering parenthood. This review will address these issues. In particular, it will outline pregnancy outcomes for mothers with cystic fibrosis, issues that need to be taken into account when planning a pregnancy and the management of pregnancy for mothers with cystic fibrosis or mothers who have undergone organ transplantation as a result of cystic fibrosis.

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“…With more than half the CF patients in the U.S. now over the age of 18 years (3), conversations about family planning, contraception and pregnancy have become an everyday occurrence in adult CF clinics (4–6). There are some known complications of pregnancy in CF (5, 7), but generally, maternal outcomes are not significantly altered by pregnancy and childbirth (8, 9). However, little is known about the intersection of contraception and chronic CF medications on pregnancy and fetal and maternal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy among cystic fibrosis women in the era of CFTR modulators

Heltshe

Godfrey

Josephy

et al. 2017

Journal of Cystic Fibrosis

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BACKGROUND Little is known about how new therapies that partially correct the basic cystic fibrosis (CF) defect (ivacaftor and lumacaftor) might alter hormonal contraceptive effectiveness, impact pregnancy outcomes, or affect pregnancy timing. Examination of pregnancy rates among CF women during periods of CFTR modulator therapy initiation will provide foundation for further research in this area. METHODS The Cystic Fibrosis Foundation Patient Registry was used to examine pregnancy rates and outcomes by genotype class before, during, and after the introduction of CFTR modulator therapies between 2005 and 2014. RESULTS Among women with CF, ages 15–44 years, there was a slight downward trend in annual pregnancy rates from 2005 to 2014 (2% reduction per year, p=0.041) Among women with G551D, pregnancy rates during phase 3 ivacaftor trial years was 14.4/1000 women/year compared to 34.0/1000 prior to the trial period (relative risk [RR]=0.65; 95% CI=0.43–0.96; p=0.011) and 38.4/1000 after drug approval in June 2012 (RR=1.52 post approval compared to trial period; 95% CI=1.26, 1.83; p<0.001). Pregnancy outcomes did not significantly change between 2005 and 2014 for any genotype class. CONCLUSION Evidence of significantly increased numbers of pregnancies among women taking approved CFTR modulators is important because of the unknown risk to pregnancy and fetal outcomes. Increases may be temporary following pregnancy prevention during controlled clinical trials, or from altered perceptions about maternal survival with new approved treatments. As more women with CF become eligible to receive modulators, the CF community must study their effect on contraceptive efficacy and safety during pregnancy. With increased health and survival due to modulation, family planning topics will become more common in CF.

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Cystic fibrosis and pregnancy in the modern era: A case control study

Abstract: Pregnancy does not lead to immediate or medium-term adverse effects for CF patients.

Cited by 37 publications

References 15 publications

Maternal and perinatal outcomes of pregnancies in women with cystic fibrosis – A single centre case-control study

Maternal and perinatal outcomes of pregnancies in women with cystic fibrosis – A single centre case-control study

Pregnancy and cystic fibrosis: Approach to contemporary management

Pregnancy among cystic fibrosis women in the era of CFTR modulators

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