Aggressive prenatal care results in successful fetal outcomes in CF women

Abstract 

Background

The impact of pre-pregnancy pulmonary and nutritional status in pregnancy outcomes of women with cystic fibrosis (CF) is not clearly defined.

Methods

A chart review of CF women who attended the University of Washington Medical Center (UWMC), Seattle WA. from January 1989 until May 2004.

Results

There were 43 pregnancies resulting in 36 live births among 25 of 189 CF women. In the subset of CF women receiving their obstetric care at the UWMC whose FEV₁ was <50% predicted, infant weight was lower than in women with a higher FEV₁ (2.9 kg±0.4 (range 2.2–3.3 kg) versus 3.4±0.8 kg (range 2.5–5.1 kg)) p=0.05 although the gestational ages were the same (37±2 weeks (range 33–39 weeks) versus to 38±2 weeks (range 35–40 weeks) p=0.17). Infant weight and gestational age of women whose initial BMI was <20 kg/m² was no different from women with a normal initial BMI (3.0±0.4 kg, range 2.2–3.4 kg versus 3.3±0.8 kg, range 2.6–5.1 kg p=0.29, and 37.7±2.4 weeks, range 33–39 weeks versus 37.2±2.1 weeks, range 34–40 weeks).

Conclusions

CF women with severe pulmonary impairment tend to have lower weight babies but it remains difficult to determine prospectively which CF women will tolerate pregnancy well. Aggressive antepartum management is recommended for all CF women.

Keywords: Cystic fibrosis, Pregnancy, TPN, Nutrition, CFRDM, Pulmonary function