Cystic Fibrosis (CF) and Pregnancy – What You Need to Know

Many times, prenatal diagnosis can lead to early detection of Cystic Fibrosis. Though during the pregnancy period, the condition may get worse and cause respiratory or other symptoms. However, it is possible to get pregnant and carry the baby to its term. Read this article to know the pregnancy outcomes for a mother with Cystic Fibrosis and how to manage pregnancy health with a disciplined lifestyle and routine.

What Is Cystic Fibrosis? 

Cystic Fibrosis is a genetic illness that can affect multiple or all organs of the body. It often causes digestion issues, lung infections leading to respiratory failure. The inherited disease makes the body produce an abnormal quantity of thick and sticky mucus built up in the lungs and pancreas, affecting the respiratory system, pancreas, digestive system, liver, and intestines. The accumulation of mucus causes harmful bacteria to grow in the body.

There is no permanent cure for this disease, however with the improved advancement in treatment, the life expectancy of such patients continues to increase, including women who are getting into the world of motherhood.

What Causes Cystic Fibrosis 

Cystic Fibrosis is inherited genetically. Thus it gets passed on from parents to children through genes. It is caused by the mutation in a gene known as Cystic Fibrosis Transmembrane Conductance Regulator (CFTR). The CFTR gene makes a protein responsible for controlling water and salt movement in and out of your body’s cells. This helps in the production of thin and freely flowing mucus.

When the CFTR gene does not work properly in the body, a thick and sticky mucus builds up. This leads to infection and salty sweat. The mucus clogs the air passage and other ducts and causes Cystic Fibrosis.  

A child inherits a copy of the gene from each parent. When someone inherits a mutated CFTR gene from one parent and a normal CFTR from the other, the person becomes Cystic Fibrosis Carrier. They are usually healthy. However, they are prone to pass the mutated CFTR gene on to their children. Performing carrier testing is a good idea before getting pregnant.

Symptoms of Cystic Fibrosis

Cystic Fibrosis symptoms differ from one person to person and depend on the severity of the disease. The symptoms may continue to improve or worsen with time. People with CF have the following symptoms:

• Higher levels of salt in the sweat than the normal levels.
• Frequently occurring sinusitis
• Persistently coughing, producing thick mucus
• Recurring lung infections
• Stuffy nose or inflamed nasal passage
• Infertility in men
• Lack of weight gain and growth
• Blockage in the intestines of the newborn
• Severe constipation causing rectal prolapse
• Troubled bowel movements with foul-smelling and greasy stools

Cystic Fibrosis Effects on Pregnancy 

Pregnancy complications who have CF may differ from one person to another. The growing baby could put pressure on the lungs and make it difficult for the mother to breathe. Women often have constipation.  Below listed are some effects during pregnancy:

1. Hypertension (High Blood Pressure) 

During pregnancy, high blood pressure results in increased resistance because of harder blood vessels. This can reduce blood flow to the baby, slow down the baby’s growth, and lead to premature delivery.

2. Premature Delivery 

Major respiratory issues, weight gain, and even poor nutrition increase the chance of premature delivery. Babies born before the 37th week of pregnancy may experience infections and can have breathing issues.

3. Gestational Diabetes 

This happens during pregnancy when a mother has high blood sugar. It can cause issues and difficulties in the developing baby. Diabetes can damage a patient’s eyes and kidneys.

4. Respiratory Issues 

With Cystic Fibrosis, breathing issues escalate quickly in people. It is crucial to get this symptom treated aggressively to receive the required oxygen for the mother’s body and the baby.

5. Nutritional Deficiency 

This can prevent the baby from growing in the womb properly. It could lead to problems in gaining weight by the mother and prevent in maintaining acceptable nutritional requirements.

How Is CF Treated During Pregnancy?

There is no permanent cure for CF. Your treating doctor will guide you through the process. With the advancement in medical sciences, there are numerous treatments available to reduce the symptoms of cystic fibrosis and minimize the menace of complications. Below are some of the ways to treat cystic fibrosis.

• Chest Therapy is a common technique where the head is placed over the edge of the bed and the clap with cupped hands along the sides of the chest. The therapy helps in the loosening of the lungs and makes it easier to cough up. This is performed three to four times a day.
• A proper diet plan with fiber and salt in higher quantities should be included in the dietary intake.
• Drink a lot of fluids at regular intervals to thin the mucus in the lungs
• Draw a fitness plan. Do regular and simple exercises like walking, cycling, etc., to clear the airway passage of the lungs.
• Smoke, molds, and pollen to be avoided at all times
• Medicines prescribed by your treating doctor. These would generally include Mucus thinning medicines, Antibiotics, bronchodilators
• Use of feeding tubes to supply essential nutrients when cystic fibrosis restricts the digestive system and prevents absorption of nutrients from food.
• Based on the severity of the illness, the treatment may require surgeries like bowel surgery to remove the blockage from the bowel system or even lung transplant to improve a person’s quality of life and longevity.

Tips for Getting Pregnant With Cystic Fibrosis 

There is a possibility of passing cystic fibrosis to a baby. It is important to get monitored regularly and be extra cautious through the nine months of pregnancy to ensure the two of you are safe and healthy. Below are some tips to follow:

• Consult a high-risk obstetrician before you plan to conceive. The specialist will assess your health, determine if it is the right time and safe for you to get pregnant, and will be your guide through the pregnancy period.
• During pregnancy, prenatal screening and diagnosis should be performed. The tests will show if your baby is likely to have cystic fibrosis or become one of the gene mutations that cause CF.
• CVS (Chronic villus sampling) test is carried out between the tenth and thirteenth week of pregnancy. Another test, Amniocentesis, is done between the fifteenth and the twentieth week of pregnancy.
• Consult a pulmonologist who will work closely with you to treat your CF throughout your pregnancy.
• Continue your treatment for CF. Do not stop the CF treatment during prenatal care checkups.
• Inform your health care providers and prenatal providers, first about your pregnancy and secondly about all the medicines you take.
• During pregnancy, you are eating for two, hence eating right is critical. Take nutritious food to meet the nutrients and calorie requirements.
• Eat many fruits and vegetables, drink enough water, and add fiber to your diet to avoid constipation.
• Exercise daily to keep your lungs healthy. Consult your doctor and nutritionist to ensure the exercises are safe for you
• Regularly monitor your health and ensure any other conditions like liver diseases and diabetes are in check.
• It is best not to stop or change your medicines without consulting your doctor. Generally, most medications used for treating CF are considered safe for the mother and the baby.

FAQ’s 

Below are some frequently answered questions related to cystic fibrosis and pregnancy.

1. Can You Get Pregnant If You Have Cystic Fibrosis? 

Yes, you can be pregnant if you have cystic fibrosis. Most women have healthy pregnancies, and their babies are born fine. Even in situations where CF affects the reproductive system, it prevents a woman from getting pregnant. It is better to consult your health care provider to assess and gauge any potential risks before you get pregnant.

2. Is Cystic Fibrosis Harmful in Pregnancy? 

Most women will not face any fertility issue or pregnancy complication with the presence of cystic fibroids. However, on a case-to-case basis and depending on the severity of the illness, complications like hypertension, preterm birth, gestational diabetes may show up. In case you are already pregnant, perform cystic fibrosis testing during pregnancy. This will help you find out if your fetus has cystic fibrosis or is a carrier.

3. Can You Breastfeed Your Baby If You Have CF? 

Yes, you can safely breastfeed your baby without compromising their health. Mother’s milk is the best food for the baby. When you have CF, it will take a lot of energy for the body to make milk. This may lead to problems in getting enough calorie intake for you and your baby. It is important to work with a dietician for a proper meal plan so that your body gets the required amounts of calories daily.

Cystic Fibrosis does not stop you from starting a family. You will need to make an effort for that extra care and little preparation. Consult your doctor to assess any potential risk before becoming pregnant. It would help if you worked closely with your treating doctor and other care providers. It is important to take good care throughout the pregnancy period to ensure the best possible result for your baby and yourself.

Also Read:

Couvade Syndrome in Pregnancy
Thalassemia during Pregnancy
Sickle Cell Disease in Pregnancy