Surveillance of pregnancy in women with cystic fibrosis
Lucy Mackillop (Oxford University Hospitals NHS Trust, Oxford)
Marian Knight (NPEU)
Severe maternal morbidity and mortality
Wellbeing of Women
Pre-pregnancy lung function is often cited as the most important factor in predicting the outcome of pregnancy for both mother and baby.
Maternal forced expiratory volume in one minute (FEV1) of less than 60% correlates with increased risk of premature delivery, delivery by caesarean section and adverse fetal outcomes such as low birth weight and perinatal death.
Based on the limited published evidence, a guideline was published in 2008 for the management of pregnant women with CF5 which states that along with pre-existing pulmonary hypertension and cor pulmonale, an FEV1 of less than 50% predicted should be suggested as an absolute contraindication to pregnancy.
However, successful pregnancies have been documented in women with much greater impairment in lung function and pre-pregnancy FEV1 between 20% and 30% predicted are reported, leading to the suggestion that advising such women to avoid pregnancy may be unwarranted.
Further study is clearly necessary to clarify the current outcomes for pregnancy in women with CF across the spectrum of lung function.
It is hoped that the results obtained from this study will guide medical professionals in supporting the care of women both planning and during pregnancy and ultimately enabling them to make informed choices regarding pregnancy and planning a family.
This study will use the UK Obstetric Surveillance System (UKOSS) to determine the incidence and risk factors of CF in pregnancy and examine the management of the condition as well as maternal and neonatal outcomes.