OUTCOME OF PREGNANCY IN WOMEN WITH CYSTIC-FIBROSIS

Background - As women with cystic fibrosis are living longer, pregnanc y is becoming increasingly common. The combined experience of pregnanc ies in women with cystic fibrosis from adult centres in the Midlands a nd North of England has been examined. Methods - A retrospective study of the case notes of 22 pregnancies in 20 patients with cystic fibros is examined changes in lung function, body weight, and microbiological status during the course of pregnancy. Duration of pregnancy, birth w eight, and maternal survival were amongst other variables studied. The relation between values before pregnancy and important outcome measur es were examined. Results - Eighteen of 22 pregnancies were completed producing healthy, non-cystic fibrosis infants (12 female). Mothers lo st 13% of FEV(1) and 11% of FVC during pregnancy, most of which was re gained. Body weight changes were variable, but most mothers gained wei ght (mean weight gain 5.7 kg). Microbiological status remained unchang ed. Six infants were preterm and two were light for dates. Four mother s died up to 3.2 years following delivery. Of the prepregnancy paramet ers examined, %FEV(1) showed the best correlation with maternal weight gain, gestation, birth weight, and maternal survival. Conclusions - P regnancy was well tolerated by most mothers with cystic fibrosis altho ugh those with moderate to severe lung disease (%FEV(1) <60%) before p regnancy fared worse, producing preterm infants and suffering increase d loss of lung function and mortality compared with mildly affected mo thers. Prepregnancy %FEV(1) appears to be the most useful predictor of important outcome measures in pregnancies in women with cystic fibros is.