The following is a summary of “Maternal and fetal outcomes in multiparous women with Cystic Fibrosis,” published in the July 2024 issue of Pulmonology by Cohen-Cymberknoh et al.

As advancements in Cystic Fibrosis (CF) management have significantly improved quality of life and longevity, family planning has become a viable consideration for women with CF (wwCF). While maternal and perinatal outcomes in this population mirror those observed in the general populace, the impact of multiple pregnancies remains uncertain.

In this multinational-multicenter retrospective cohort study, data from 18 global centers were gathered anonymously, focusing on wwCF aged 18-45. Parameters encompassed disease severity, obstetric outcomes, and newborn complications. Analysis was conducted both within individual patients to compare outcomes between initial pregnancies (1st or 2nd) and multigravid pregnancies (≥3), as well as through grouped data to identify risk factors for disease progression and adverse neonatal outcomes across three distinct periods: before, during, and after pregnancy.

The study encompassed 141 wwCF, with 41 (29%) experiencing three or more pregnancies, termed “multiparous.” A comprehensive review of 246 pregnancies spanning from 1973 to 2020 revealed that 69 (28%) were multigravid. Notably, multiparous women demonstrated a more pronounced decline in postpartum forced expiratory volume in one second (ppFEV1), particularly evident among those with pancreatic insufficiency (PI) and two severe mutations. Multigravid pregnancies were characterized by shorter gestational periods, particularly prominent in wwCF over 30 years old, who exhibited elevated rates of preterm birth and neonatal complications. However, no discernible impact on pulmonary exacerbations or disease-related complications was observed.

In conclusion, multiple pregnancies in wwCF appear to correlate with accelerated respiratory deterioration and increased incidence of preterm births. Consequently, meticulous monitoring by a multidisciplinary team comprising CF and obstetric specialists is imperative for women contemplating or undergoing multiple pregnancies, facilitating proactive management strategies tailored to mitigate associated risks effectively.

Source: sciencedirect.com/science/article/abs/pii/S0954611124001288