When you have cystic fibrosis, it’s still possible to get pregnant and carry a baby to term. However, you’ll need to be monitored closely during these nine months to ensure that both you and your little one stay healthy.
To give yourself the best opportunity of achieving a successful pregnancy, see a high-risk obstetrician before you try to conceive.
This specialist will:
- evaluate your health
- determine whether it’s safe for you to get pregnant
- guide you through pregnancy
You’ll also work closely with the pulmonologist who treats your cystic fibrosis throughout your pregnancy.
Here’s a preview of what to expect as you begin planning a family.
During pregnancy, your cystic fibrosis symptoms may get worse. The growing baby can put pressure on your lungs and make it harder to breathe. Constipation is also common in women with cystic fibrosis.
Other cystic fibrosis pregnancy complications include:
- Premature delivery. This is when your baby is born before the 37th week of pregnancy. Babies who are born too early are at risk of complications like breathing difficulties and infections.
- Gestational diabetes. This is when the mother has high blood sugar during pregnancy. Diabetes can damage organs like the kidneys and eyes. It can also cause complications in the developing baby.
- High blood pressure (hypertension). This is increased resistance due to stiffer blood vessels. When blood pressure is high during pregnancy, it can reduce blood flow to your baby, slow your baby’s growth, and lead to premature delivery.
- Nutritional deficiency. This can prevent your baby from growing enough in the womb.
There’s a possibility you could pass cystic fibrosis to your baby. For that to happen, your partner also needs to carry the abnormal gene. Your partner can get a blood or saliva test before you conceive to check his carrier status.
During pregnancy, these two prenatal tests look for the most common gene mutations. They can show whether your baby is likely to have cystic fibrosis or carries one of the gene mutations known to cause cystic fibrosis:
- Chorionic villus sampling (CVS) is done between the 10th and 13th weeks of pregnancy. Your doctor will insert a long, thin needle into your belly and will remove a sample of tissue for testing. Alternately, the doctor can take a sample using a thin tube placed into your cervix and gentle suction.
- Amniocentesis is done between the 15th and 20th weeks of your pregnancy. The doctor inserts a thin, hollow needle into your belly and removes a sample of amniotic fluid from around your baby. A lab then tests the fluid for cystic fibrosis.
These prenatal tests can cost a few thousand dollars, depending on where you have them done. Most health insurance plans will cover the cost for women over age 35 and for women with known risks.
Once you know whether your baby has cystic fibrosis, you can make decisions about the future of your pregnancy.
A little bit of planning and extra care during your pregnancy will help ensure the best possible outcome for both you and your baby. Here are a few things you can do.
Cystic fibrosis makes it harder to get proper nutrition during pregnancy. When you’re eating for two, it’s even more critical that you get enough calories and nutrients.
Your doctor may recommend starting your pregnancy with a body mass index (BMI) of at least 22. If your BMI is lower than that, you may need to increase your calorie intake before you conceive.
Once you’re pregnant, you’ll need an extra 300 calories daily. If you can’t reach that number with food alone, drink nutritional supplements.
Sometimes severe morning sickness or cystic fibrosis can prevent you from getting enough calories to meet your baby’s needs. In this case, your doctor might suggest getting your nutrition intravenously. This is called parenteral nutrition.
Here are a few other nutritional tips to follow during your pregnancy:
- Drink lots of water, eat more fruits and vegetables, and add fiber to your diet to prevent constipation.
- Make sure you get enough folic acid, iron, and vitamin D. These nutrients are essential to your baby’s development. Sometimes people with cystic fibrosis don’t get enough of them.
Physical activity is important to get your body in shape for delivery and keep your lungs healthy. Your doctor may recommend you do special exercises to strengthen the muscles that help you breathe. Check with your doctor first that the exercises you do are safe for you.
Also, consult a dietitian before you start any new exercise program. You need enough nutrition to support your increased calorie requirements.
Other tips to ensure a healthy pregnancy
See your doctors often. Schedule regular prenatal visits with your high-risk obstetrician, but also continue to see the doctor who treats your cystic fibrosis.
Monitor your health. Keep on top of conditions like diabetes and liver disease, if you have them. These diseases can cause pregnancy complications if you don’t treat them.
Stay on your medications. Unless your doctor has specifically told you to stop a medication during pregnancy, take it regularly to manage your cystic fibrosis.
Medication is a necessary part of managing cystic fibrosis. The good news is, most medications that treat the condition are considered safe for your baby.
However, there are a few drugs you should use with caution. There’s a slight chance they could increase the risk of birth defects or other problems in your unborn baby. Drugs to watch include:
- antibiotics like ciprofloxacin (Cipro), clarithromycin, colistin, doxycycline (Oracea, Targadox), gentamicin (Gentak), imipenem (Primaxin IV), meropenem (Merrem), metronidazole (MetroCream, Noritate), rifampin (Rifadin), trimethoprim-sulfamethoxazole (Bactrim), vancomycin (Vancocin)
- antifungal drugs like fluconazole (Diflucan), ganciclovir (Zirgan), itraconazole (Sporanox), posaconazole (Noxafil), voriconazole (Vfend)
- antiviral drugs such as acyclovir (Zovirax)
- bisphosphonates to strengthen bones
- cystic fibrosis drugs like ivacaftor (Kalydeco) and lumacaftor/ivacaftor (Orkambi)
- ranitidine (Zantac) to treat heartburn and gastroesophageal reflux
- transplant medications to prevent rejection, such as azathioprine (Azasan), mycophenolate
- ursodiol (URSO Forte, URSO 250) to dissolve gallstones
Talk to your doctor if you take any of these medications. You’ll need to weigh the benefits and risks of staying on any drugs that could cause problems during pregnancy. Your doctor may be able to switch you to an alternate drug until you deliver.
Most women with this condition can get pregnant, but it could take a little longer than usual. Cystic fibrosis thickens mucus throughout the body — including mucus in the cervix. Thicker mucus makes it harder for the man’s sperm to swim into the cervix and fertilize an egg.
Nutritional deficiencies can also prevent you from ovulating regularly. Every time you ovulate, your ovary releases an egg for fertilization. Without an egg in place each month, you may not be able to conceive as easily.
If you’ve tried for several months to get pregnant, but you haven’t been successful, talk to a fertility specialist. Medications to increase your egg production or assisted reproductive technologies such as in-vitro fertilization may improve your chances of conceiving.
Men with cystic fibrosis lack or have a blockage in the tube that carries sperm from the testicle to the urethra for ejaculation. Because of this, most can’t conceive naturally.
They and their partner will need IVF to conceive. During IVF, the doctor removes an egg from the woman and sperm from the man, combines them in a laboratory dish, and transfers the embryo into the woman’s uterus.
Before you start IVF, talk to the doctor who treats your cystic fibrosis. You may have to adjust your treatment, because cystic fibrosis can affect the absorption of hormones needed for IVF.
Having cystic fibrosis shouldn’t prevent you from starting a family. Getting pregnant might just take a little extra preparation and care.
Once you do conceive, work closely with both a high-risk obstetrician and the doctor who treats your cystic fibrosis. You’ll need good care throughout your pregnancy to ensure the best possible outcome for both you and your baby.