McMullen Ann H, Pasta David J, Frederick Paul D, Konstan Michael W, Morgan Wayne J, Schechter Michael S, Wagener Jeffrey S
University of Rochester School of Nursing, 601 Elmwood Avenue, Rochester, NY 14642, USA.
Chest. 2006 Mar;129(3):706-11. doi: 10.1378/chest.129.3.706.
Improvements in the health and survival of patients with cystic fibrosis (CF) have led to increasingly normal lifestyles, including successful pregnancies in women with CF. Concern exists among care providers about the impact of pregnancy on the health of women with CF.
We examined data from a large longitudinal observational study, the Epidemiologic Study of Cystic Fibrosis (ESCF), to characterize health outcomes and CF-related therapies in women who became pregnant.
This analysis was conducted using ESCF data from 1995 to 2003.
A total of 216 women, aged 15 to 38 years, who met the criteria for a qualifying pregnancy, were compared with a matched group of never-pregnant women during three time periods (ie, baseline, during pregnancy, and follow-up).
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The baseline pulmonary function (FEV(1)) values were 74.5% and 66.4% predicted, respectively, in the pregnant and nonpregnant women. Declines in FEV(1) values of 6.8% and 4.7%, respectively, were observed from baseline to follow-up in the pregnant and nonpregnant women (p = 0.61). During pregnancy, outpatient visits were 33% more frequent compared to baseline and 62% more frequent than in the nonpregnant group (7.19 vs 4.45, respectively, visits annually). Annual rates of respiratory exacerbation and hospitalization were similar at baseline but increased during pregnancy. The prevalence of treatment for diabetes more than doubled, from 9.3% at baseline to 20.6% during pregnancy, and was 14.4% at follow-up. In contrast, 18.7% of the never-pregnant women were being treated for diabetes at baseline, rising to 25.2% at follow-up.
These findings suggest that, over the same time period, women with CF who become pregnant experienced similar respiratory and health trends as nonpregnant women. However, pregnant women use a greater number of therapies and receive more intense monitoring of their health. These findings have implications for clinicians providing prepregnancy counseling for women with CF.
囊性纤维化（CF）患者健康状况和生存率的改善使他们的生活方式日益正常化，包括CF女性成功怀孕。医疗服务提供者担心怀孕对CF女性健康的影响。
我们分析了一项大型纵向观察性研究——囊性纤维化流行病学研究（ESCF）的数据，以描述怀孕女性的健康结局和CF相关治疗情况。
本分析使用了1995年至2003年的ESCF数据。
共有216名年龄在15至38岁之间、符合合格妊娠标准的女性，在三个时间段（即基线期、孕期和随访期）与一组匹配的未孕女性进行比较。
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怀孕和未孕女性的基线肺功能（FEV₁）值分别为预测值的74.5%和66.4%。从基线期到随访期，怀孕和未孕女性的FEV₁值分别下降了6.8%和4.7%（p = 0.61）。孕期门诊就诊次数比基线期增加了33%，比未孕组增加了62%（每年分别为7.19次和4.45次就诊）。呼吸加重和住院的年发生率在基线期相似，但在孕期增加。糖尿病治疗的患病率增加了一倍多，从基线期的9.3%增至孕期的20.6%，随访期为14.4%。相比之下，18.7%的未孕女性在基线期接受糖尿病治疗，随访期升至25.2%。
这些发现表明，在同一时期，怀孕的CF女性与未孕女性经历了相似的呼吸和健康趋势。然而，怀孕女性使用的治疗方法更多，且对其健康的监测更密集。这些发现对为CF女性提供孕前咨询的临床医生具有启示意义。
