For women with cystic fibrosis, multiple pregnancies lead to higher rates of preterm births and faster respiratory decline, according to a retrospective cohort study.
Researchers looked at the medical records of 141 women with cystic fibrosis across 18 centres worldwide. They obtained data on disease severity and outcome, in addition to obstetric and newborn complications.
Individual patient data were analysed to compare outcomes between women with an initial pregnancy (first or second) and those with a multigravid pregnancy (≥3). Secondary analysis was also conducted to determine risk factors for disease progression or adverse neonatal outcomes. Three time periods were evaluated, namely before, during, and after pregnancy.
Of the women, 41 (29 percent) had ≥3 pregnancies. Analysis of data from 246 pregnancies (28 percent multiparous) showed that the percent predicted forced expiratory volume (ppFEV1) was greatly reduced in multiparous women, especially those with pancreatic insufficient cystic fibrosis and those with two severe (class I-III) mutations.
Furthermore, multigravid pregnancies were shorter, especially among women over 30 years of age who had high rates of premature births and newborn complications.
Multigravid pregnancies showed no association with pulmonary exacerbations or disease-related complications.
The findings underscore a strict follow-up in women with cystic fibrosis who plan to have multiple pregnancies.