Abstract Background A minority of people with bronchiectasis have onset of disease in childhood and adolescence; these people face the challenges of parenthood while living with a chronic illness. Literature on fertility and pregnancy outcomes on women with CF exists, but obstetric outcomes of women with bronchiectasis have not been described. We aimed to describe fertility treatments and obstetric outcomes in women with bronchiectasis. Methods We conducted a retrospective, multicenter, multinational cohort study across bronchiectasis referral centers. Female patients with a documented diagnosis of bronchiectasis given prior to conception or during pregnancy and up to three months postpartum between 2012 and 2023 were eligible for inclusion. We collected demographic data and data on bronchiectasis related features before pregnancy, and obstetrics and neonatal outcomes. Results A total of 83 women were included, with 121 pregnancies and 123 neonates. The mean (SD) age at conception was 29.5 (5.3) years and mean (SD) BMI at conception was 21 (6.39) Kg/m2. The leading bronchiectasis etiologies were PCD (27.3%), post-infectious (13.8%), and immunodeficiency (13.2%). Data on fertility treatments for the pregnancies were available for 56 of the pregnancies. ART were used in 18 pregnancies (32.1%). Women with PCD received ART more often than women without PCD: 16 of 33 women with PCD (48.5%) vs. 2 of 23 women with other aetiologies, p = 0.004. Pulmonary function, as assessed by pre-pregnancy FEV1, averaged 75.94% (SD 22.3) for the highest documented value in the 12 months pre-conception and 71.69% (SD 24.2) for the lowest value. No pregnancy was complicated with gestational diabetes (0/107). No significant deterioration in lung function was observed during or after pregnancy. Weight gain during pregnancy was a mean (IQR) 9 (3-13.8) Kg. Exacerbations occurred in 58.6% of pregnancies and 70% of women experienced ≥1 exacerbation postpartum (mean 1.38, SD 1.28). The mean (SD) birthweight of newborns was 2.997 kg (0.51), and most infants were delivered at term (mean gestational age 39 weeks). Pre-pregnancy FEV1 was positively correlated to birth weight (r = 0.42, p = 0.001, N = 55) and to gestational age (r = 0.25, p = 0.042, N = 66, figure). Most deliveries were vaginal (74.7%), with only minor neonatal malformations reported (4 of 95, 4.2%). Apgar scores were normal in nearly all cases (1-minute 7 in 98.6%, 5-minute 7 in 100%). Conclusion Obstetric outcomes are usually good in women with bronchiectasis. Fertility treatments are required more often in women with PCD. Birth weight and gestational week are correlated with maternal FEV1. This abstract is funded by: None
Shteinberg et al. (Fri,) studied this question.