601: The unintended consequences of normal pregnancy: pulmonary function of a spouse affected by cystic fibrosis

A neglected area of investigation is the effect of pregnancy on a chronically ill spouse of a healthy pregnant woman. Although the partner does not carry the pregnancy nor suffers physiologic changes directly due to this condition, pregnancy and parenting may alter the disease state. This is especially true in debilitating and potentially life-threatening conditions like cystic fibrosis (CF). Thus, the aim of this study was to determine the effect of pregnancy on pulmonary function and disease course of a CF partner of healthy pregnant women. This was a retrospective cohort study of all spouses with CF who attended our national CF clinic and had their female partner pregnant with their firstborn between 2010 and 2016. We compared annual rates of respiratory exacerbation and hospitalizations, weekly frequency of chest physiotherapy, number of outpatient visits and pulmonary function during three time periods: a year prior to pregnancy, during pregnancy and a year following pregnancy. Non-parametric statistical methods were employed. Twelve individuals with CF at a median age of 31 had their firstborn during that time period. 11 (92%) pregnancies were conceived through Artificial Reproductive Technology. 10 spouses (83.3%) had pancreatic exocrine insufficiency, and 5 (41.6%) had CF-related diabetes mellitus. The baseline pulmonary function measured through forced expiratory volume in 1 second (FEV1) was 65.3% predicated. Spouses lost an average of 10% of their FEV1, 16% of their forced vital capacity and 15% of their forced expiratory flow 25-75% from a year prior to pregnancy to a year following pregnancy (p=0.027, 0.04 and 0.027, respectively). Similar decline in FEV1 value of 7% was observed from baseline to pregnancy (p=0.018). Annual rates of respiratory exacerbation and hospitalization, weekly frequency of chest physiotherapy and annual number of outpatient visits did not differ significantly before, during and after pregnancy. No spouse had undergone lung transplantation or died during the follow-up period. To the best of our knowledge this is the first study to examine the physiologic effects of pregnancy on a spouse with CF. Our findings suggest that spouse’s pregnancy and parenting may lead to deterioration in pulmonary function of partners with CF. These findings have implications for clinicians providing prepregnancy counseling for both women and their significant other with CF.