Pregnant women with cystic fibrosis (CF) are considered high-risk pregnancies, but there are many ways to reduce the risk of complications for a safe pregnancy.
The good news is that most women who have CF are able to become pregnant and carry a healthy child to term. Of course, there are many factors to consider that can have implications on your health. Here is what you should know about complications you may encounter and how to maintain a healthy pregnancy.
Cystic Fibrosis and Complications During Pregnancy
When you have CF, you can expect more complications and medical care during your pregnancy than a woman who does not have CF. The good news is there is a very good chance of delivering a healthy baby with stillbirth, premature delivery and miscarriage rates for CF patients dropping rapidly over the last few decades. Today, 70 percent to 90 percent of pregnancies are live births.
The most common risks your baby can face during pregnancy include:
- Premature delivery
- Low birth weight
Beginning your pregnancy at a healthy weight and meeting your nutritional needs can dramatically reduce these risks.
One of the most serious dangers of pregnancy is its effect on your CF. Researchers found that women with CF who became pregnant tended to be healthier and have a higher 10-year survival rate than women who did not become pregnant, but every woman responds to the strain of pregnancy differently. About 20 percent of mothers with CF will not live to see their child turn 10 years old. This increases to 40 percent of mothers who had poor lung function when they became pregnant.
Diabetes is another common concern for CF patients because gestational diabetes is more common in women with CF. Failing to diagnose and treat diabetes can increase complications for you and your child. The Cystic Fibrosis Trust currently recommends glucose tolerance testing during the first trimester and again at 24 to 28 weeks if you had normal glucose test results before pregnancy.
Pregnancy After a Lung Transplant
Many women with CF face the possibility of a lung transplant at some point. If you have undergone a transplant, you can still become pregnant, but there is a higher risk of complications. Transplant lung recipients who become pregnant face higher risks of:
- Premature delivery
- Lung rejection
- Reduced lung function
For your child, premature birth is the greatest risk, which may be 50 percent higher for women with CF who have had a lung transplant. The greatest risk to you during pregnancy is transplant rejection. People who have received a lung transplant have a higher rejection rate during pregnancy than people who have received other solid organ transplants.
It’s usually recommended to avoid getting pregnant within the first three years of your lung transplant surgery to reduce these risks.
Tips for a Healthy Pregnancy
Ideally, it’s important to work on your nutrition and health before you become pregnant. Many women with CF have difficulty meeting the additional calorie needs during pregnancy. Beginning your pregnancy with a healthy body mass index can reduce the risk of premature deliver and miscarriage. Throughout your pregnancy, you will work closely with your CF management team to monitor your blood glucose level, lung function, nutrition and weight. Your weight and nutrition will be watched closely. If you have difficulty gaining weight, your physician may recommend nutritional supplements or tube feeding to meet your pregnancy requirements.
You will continue most of your medications and treatments during pregnancy, although it’s important to review your medications with your doctor before you try to conceive. There will likely be some medications that are not safe to take during pregnancy, such as some oral medications and antibiotics.
Conceiving and maintaining a healthy pregnancy can seem like a big hurdle with CF, but it is possible. Ensuring you are at a healthy weight and have good lung function before you get pregnant, and taking steps to watch your nutrition during pregnancy, are the best things you can do to ensure a safe and healthy pregnancy with as few complications as possible.