Background

With women with cystic fibrosis (CF) increasingly pursuing pregnancy [1], optimisation of antenatal care remains vital [2]. The complex pathophysiology of diabetes in pregnant women with CF (PwCF) may confer unique clinical consequences, yet few studies have directly compared outcomes between PwCF with and without diabetes in pregnancy. This study aimed to compare maternal and fetal outcomes in PwCF with and without evidence of hyperglycemia during pregnancy to clarify whether the adverse outcomes associated with diabetes in PwCF are distinct from those observed in other forms of diabetes. 

Method

We undertook a retrospective cohort study of pregnancies to women with CF receiving antenatal care at Monash Health between 2004 and 2023. A total of 43 pregnancies among 25 women were identified, along with birth records for 29 infants born to these women. 

Results

Overall outcomes were favourable in cohort, with no serious adverse events of maternal or fetal deaths. PwCF with either pre-existing cystic fibrosis related diabetes or gestational diabetes mellitus had similar short term maternal outcomes compared to non-diabetic patients but poorer long term respiratory function and a higher rate of caesarean section, preterm birth, low birth weight and infant admission. There was no evidence supporting increased risk of pre-eclampsia, macrosomia, fetal malformation or shoulder dystocia as seen in other forms of diabetes [3, 4].

Conclusion 

Diabetes presents unique maternal and fetal risks in PwCF compared to other forms of diabetes, necessitating specialised guidelines focused on optimising maternal health and ensuring adequate perinatal care for the neonate.