囊性纤维化女性的当前妊娠结局。

Current pregnancy outcomes in women with cystic fibrosis.

机构信息

Registrar Obstetrics and Gynaecology, Maternal Medicine Department, University Hospitals Bristol, Southwell Street, Bristol BS2 8EG, UK.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2012 Oct;164(2):142-5. doi: 10.1016/j.ejogrb.2012.06.013. Epub 2012 Jul 9.

DOI:10.1016/j.ejogrb.2012.06.013

PMID:22784584

Abstract

OBJECTIVES

Women with cystic fibrosis (CF) now achieve a greater life expectancy and therefore have greater expectations from life. Literature reporting pregnancy outcomes in CF is still sparse. There remains a legacy of advising women with significant disease to avoid pregnancy. We aimed to assess current maternal and fetal outcomes in women with CF with varied pre-pregnancy lung function.

STUDY DESIGN

Retrospective case note review of data from 15 pregnancies in 12 women with CF receiving care at a specialist centre between 2003 and 2011. Descriptive statistics were used for the quantitative data. The forced expiratory volume (FEV₁) and forced vital capacity (FVC) were calculated and shown as the percentage of their predicted values for BMI, height and age. Changes in lung function pre, 6, and 24 months post delivery were calculated with the paired t-test.

RESULTS

Mean maternal age was 28.9 (range 21-36, CI 26.8-31). Maternal FEV₁ at booking ranged from 27 to 80% predicted (mean=63.6%, CI 54.62-71.38%). Cystic fibrosis-related diabetes (CFRD) was present in 8 of 14 (live birth) pregnancies. Average gestation at delivery was 38 weeks. There was a 100% vaginal delivery rate (11 spontaneous vertex, 2 ventouse, 1 forceps). Average fetal birth weight was 2.97 kg (range 2.2-3.83 kg, CI 2.72-3.23). The differences between the maternal pre- and 6 months post-pregnancy mean FEV₁ (p=0.136) and FVC (p=0.225) were not statistically significant.

CONCLUSION

With careful multidisciplinary antenatal and intrapartum management, successful outcomes have been obtained in this group of women with CF.

摘要

目的

患有囊性纤维化（CF）的女性现在预期寿命更长，因此对生活有更高的期望。关于 CF 患者妊娠结局的文献仍然很少。过去一直建议患有严重疾病的女性避免怀孕。我们旨在评估在患有 CF 的女性中，具有不同孕前肺功能的女性目前的母婴结局。

研究设计

回顾性病例记录回顾了 2003 年至 2011 年间在一家专科中心接受治疗的 12 名女性的 15 例妊娠中的数据。使用描述性统计数据对定量数据进行分析。用力呼气量（FEV₁）和用力肺活量（FVC）按其预测值除以 BMI、身高和年龄的百分比进行计算。使用配对 t 检验计算分娩前、分娩后 6 个月和 24 个月的肺功能变化。

结果

母亲的平均年龄为 28.9 岁（范围 21-36 岁，置信区间 26.8-31 岁）。预约时母亲的 FEV₁ 范围为 27%至 80%预测值（平均值=63.6%，置信区间 54.62-71.38%）。14 例（活产）妊娠中有 8 例存在囊性纤维化相关糖尿病（CFRD）。平均分娩孕周为 38 周。阴道分娩率为 100%（11 例自然头位，2 例产瘤吸引器，1 例产钳）。平均胎儿出生体重为 2.97 公斤（范围 2.2-3.83 公斤，置信区间 2.72-3.23）。母亲妊娠前和妊娠后 6 个月的平均 FEV₁（p=0.136）和 FVC（p=0.225）之间的差异无统计学意义。