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Kazmerski TM, Stransky OM, Wright CE, Albanowski M, Pilewski JM, Talabi MB, Callegari LS, Chang JC, Abebe KZ, Miller E, Deal A, O'Leary R, Borrero S. Feasibility Testing of a Web-Based Reproductive Decision Support Tool for Cystic Fibrosis. J Cyst Fibros 2024; 23:404-411. [PMID: 37833123 DOI: 10.1016/j.jcf.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/22/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND People with cystic fibrosis (CF) are increasingly considering their reproductive goals. We developed MyVoice:CF, a web-based patient-centered reproductive decision support tool and assessed its implementation in CF care. METHODS We conducted a feasibility trial among 18-44-year-old women with CF and multidisciplinary CF providers. Prior to CF clinic visit, patient participants completed a baseline survey, used MyVoice:CF, and assessed acceptability, appropriateness, and usability. After clinic, participants rated impact on reproductive health communication. At 3 months post-use, participants assessed impact on reproductive health outcomes. Provider participants completed a survey and focus group regarding MyVoice:CF feasibility/implementation. We assessed outcomes descriptively. We compared MyVoice:CF's impact on outcomes from baseline to follow-up using McNemar's and Wilcoxon signed rank tests as appropriate. RESULTS Forty-three patient participants completed baseline surveys and 40 rated MyVoice:CF's feasibility; 10 providers participated. Patient participants rated MyVoice:CF's acceptability as 4.48±0.50 out of 5, appropriateness as 4.61±0.48 out of 5, and usability as 82.25±11.02 ('A'/excellent). After MyVoice:CF use, participants reported improved reproductive health communication self-efficacy vs. baseline (3.54±1.17vs.3.95±0.93, p<0.001). At baseline, 36% of participants reported any discussion of reproductive goals/plans with their CF team in the past year compared to 59% after first visit post-MyVoice:CF use (p=0.049). Provider participants similarly rated MyVoice:CF as feasible and reported no negative impacts on clinic flow after implementation. CONCLUSIONS MyVoice:CF is acceptable, appropriate, and usable for those with CF. Preliminary effectiveness evaluation suggests that MyVoice:CF improves self-efficacy in and frequency of reproductive health communication. Future studies should further assess MyVoice:CF's impact on reproductive health communication and outcomes.
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Affiliation(s)
- Traci M Kazmerski
- University of Pittsburgh School of Medicine, Pittsburgh, PA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA.
| | - Olivia M Stransky
- University of Pittsburgh School of Medicine, Pittsburgh, PA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA
| | - Catherine E Wright
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA
| | | | | | - Mehret Birru Talabi
- University of Pittsburgh School of Medicine, Pittsburgh, PA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA
| | - Lisa S Callegari
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA; Univ of Washington, Seattle, WA
| | - Judy C Chang
- University of Pittsburgh School of Medicine, Pittsburgh, PA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA
| | - Kaleab Z Abebe
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Elizabeth Miller
- University of Pittsburgh School of Medicine, Pittsburgh, PA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA
| | - Ashley Deal
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA; Carnegie Mellon University, Pittsburgh, PA
| | - Raelynn O'Leary
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA; Carnegie Mellon University, Pittsburgh, PA
| | - Sonya Borrero
- University of Pittsburgh School of Medicine, Pittsburgh, PA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA
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Om S, M P, M B, Jl TC, Tm K. A qualitative exploration of parenthood experiences and needs among people with cystic fibrosis. J Cyst Fibros 2024; 23:424-428. [PMID: 37596197 DOI: 10.1016/j.jcf.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/17/2023] [Accepted: 08/13/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND As highly effective modulator therapy improves the lives of many people with cystic fibrosis (pwCF), more are considering or pursuing parenthood. This study explores the interplay between having CF and being a parent. METHODS We recruited pwCF with >1 child ≤10 years from CF Foundation Community Voice and participating CF centers to complete interviews exploring their decision-making process to become a parent, adjustment to parenthood with CF, the impact of CF on parenting, and the impact of parenting on CF care/adherence. We transcribed and thematically analyzed interviews using a deductive approach. RESULTS Twenty-one mothers and 16 fathers participated (age 22-46 years). Key themes included: 1) The responsibilities of parenthood and the responsibilities of CF care often conflict, requiring creative multitasking and alterations to other aspects of life; 2) Delegating tasks to partners/family can alleviate conflicts between parenting and CF care; 3) While CF teams do not play a major role in decisions to become a parent, pwCF desire support/resources specific to parenting from their CF team; 4) It is logistically and emotionally difficult to avoid illnesses transmitted from children, but some parents use precautions to mitigate risk; and 5) Parents with CF desire clinic-facilitated connections with other parents with CF to share strategies and for emotional support. CONCLUSIONS Parents with CF have unique challenges both as pwCF and as parents, and the intersection of these roles can impact their health outcomes and care adherence. Identifying common challenges may allow CF care teams to improve support of parents with CF.
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Affiliation(s)
- Stransky Om
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, 230 McKee Place, Pittsburgh, Pennsylvania 15213 USA.
| | - Pam M
- Cystic Fibrosis Reproductive and Sexual Health Collaborative, Seattle, Washington, USA
| | - Bernard M
- School of Nursing, University of Pittsburgh, 3500 Victoria Street, Pittsburgh, Pennsylvania 15261, USA
| | - Taylor-Cousar Jl
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, 1400 Jackson Street, Denver, Colorado 80206, USA; Division of Pediatric Pulmonary Medicine, National Jewish Health, 1400 Jackson Street, Denver, Colorado 80206, USA
| | - Kazmerski Tm
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, 230 McKee Place, Pittsburgh, Pennsylvania 15213 USA; Department of Pediatrics, University of Pittsburgh School of Medicine, 4401 Penn Avenue, Pittsburgh, Pennsylvania 15224, USA
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Jain R, Kazmerski TM, Taylor-Cousar JL. The modern landscape of fertility, pregnancy, and parenthood in people with cystic fibrosis. Curr Opin Pulm Med 2023; 29:595-602. [PMID: 37789771 PMCID: PMC10629848 DOI: 10.1097/mcp.0000000000001009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
PURPOSE OF REVIEW With improved long-term survival and the expanding availability of cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies that treat the underlying genetic defect in cystic fibrosis, more people are interested in parenthood. Cystic fibrosis care centers and people with cystic fibrosis need more information to guide decisions related to parenting. RECENT FINDINGS Here we present currently available data on fertility, pregnancy, and parenthood in the modern era of cystic fibrosis care. Fertility may be improving in female individuals with cystic fibrosis with the use of CFTR modulator therapies, and there is an associated increase in annual pregnancies. Infertility in male individuals with cystic fibrosis remains approximately 97-98% and is unchanged with CFTR modulators in those already born with cystic fibrosis. As more female individuals with cystic fibrosis experience pregnancy, questions remain about the impact of pregnancy on their health and that of their child. Fortunately, there are multiple routes to becoming a parent; however, more work is needed to understand the impact of pregnancy and parenthood in the context of CF as some previous data suggests potential challenges to the health of parents with cystic fibrosis. SUMMARY We encourage cystic fibrosis care teams to have knowledge and resources available to support the reproductive goals of all individuals with cystic fibrosis.
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Affiliation(s)
- Raksha Jain
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Traci M Kazmerski
- University of Pittsburgh School of Medicine, Department of Pediatrics, Pittsburgh, PA, USA
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer L Taylor-Cousar
- National Jewish Health, Departments of Internal Medicine and Pediatrics Denver, CO, USA
- University of Colorado Anschutz Medical Campus, Departments of Internal Medicine and Pediatrics, Aurora, CO, USA
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Taylor-Cousar JL, Shteinberg M, Cohen-Cymberknoh M, Jain R. The Impact of Highly Effective Cystic Fibrosis Transmembrane Conductance Regulator Modulators on the Health of Female Subjects With CF. Clin Ther 2023; 45:278-289. [PMID: 36841738 DOI: 10.1016/j.clinthera.2023.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/28/2022] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
Cystic fibrosis (CF) is a genetic disorder that occurs in people of all genetic ancestries. CF is caused by variants in the CF transmembrane conductance regulator (CFTR) gene that result in decreased, absent, or nonfunctional CFTR protein at the cell surface of the mucous membranes. Clinical manifestations include chronic respiratory disease, malabsorption, and decreased fertility. Historically, therapies for CF were focused on the signs and symptoms of the disease. However, more recently, CFTR modulators, therapies directed at the basic defect, are improving the quality and duration of the lives of people with CF. The predicted survival of people with CF in the United States is now 53 years of age. With the hope of longer, healthier lives, female individuals with CF (fwCF) are expressing the desire to discuss fertility, pregnancy, and parenthood. Furthermore, pregnancy rates are increasing substantially. Understanding the impact of use or discontinuation of highly effective modulator therapy on the reproductive health of fwCF is critical. Finally, fwCF and their providers must consider preventative cancer screening. (Clin Ther. 2023;45:XXX-XXX) © 2023 Elsevier HS Journals, Inc.
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Affiliation(s)
- Jennifer L Taylor-Cousar
- Division of Pulmonary, Critical Care and Sleep Medicine and of Pediatric Pulmonary Medicine, National Jewish Health, Denver, CO, USA.
| | - Michal Shteinberg
- Technion-Israel Institute of Technology and the B. Rappaport Faculty of Medicine, Haifa, Israel; Pulmonology Institute and CF Center, Carmel Medical Center, Haifa, Israel
| | - Malena Cohen-Cymberknoh
- Pediatric Pulmonology Unit and Cystic Fibrosis Center, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Raksha Jain
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Stransky OM, Benipal S, Pam M, Taylor-Cousar JL, Documet P, Kazmerski TM. "Find ways to work parenting into cystic fibrosis": A PhotoVoice exploration of being a parent and having CF. Pediatr Pulmonol 2023; 58:1527-1534. [PMID: 36808716 DOI: 10.1002/ppul.26355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/24/2023] [Accepted: 02/11/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND As more people with cystic fibrosis (CF) consider their reproductive futures, the impact of parenthood on CF must be better understood. In the context of chronic disease, deciding if, when, and how to become a parent is complex. Little research has investigated how parents with CF balance their role as parents with its associated health impacts and demands of CF. METHODS PhotoVoice is a research methodology that utilizes photography to generate discussion about community issues. We recruited parents with CF with at least 1 child <10 years old and divided them into three cohorts. Each cohort met five times. Cohorts developed photography prompts, took photographs between sessions, and reflected on the photos at subsequent meetings. At the final meeting, participants selected 2-3 pictures, wrote captions, and as a group organized the photographs into thematic groups. Secondary thematic analysis identified metathemes. RESULTS Participants (n = 18) generated a total of 202 photographs. Each cohort identified 3-4 themes (n = 10) which secondary analysis grouped into 3 metathemes: (1) It is important for parents with CF to pay attention to the joyful aspects of parenting and to cultivate positive experiences; (2) Parenting with CF requires balancing your own needs with those of your child, and creativity and flexibility can be key; (3) Parenting with CF consists of competing priorities and expectations often with no clear "correct" choice. CONCLUSIONS Parents with CF identified unique challenges to their existence as both parents and patients as well as ways in which parenting has enhanced their lives.
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Affiliation(s)
- Olivia M Stransky
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Savvy Benipal
- Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah, USA
| | - Molly Pam
- Cystic Fibrosis Reproductive and Sexual Health Collaborative, Seattle, Washington, USA
| | - Jennifer L Taylor-Cousar
- Divisions of Pulmonary, Critical Care and Sleep Medicine and Pediatric Pulmonary Medicine, National Jewish Health, Denver, Colorado, USA
| | - Patricia Documet
- Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Traci M Kazmerski
- Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Meiss LN, Jain R, Kazmerski TM. Family Planning and Reproductive Health in Cystic Fibrosis. Clin Chest Med 2022; 43:811-820. [PMID: 36344082 DOI: 10.1016/j.ccm.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Family planning in cystic fibrosis (CF) is an increasingly important aspect of care, as improvements in care and outcomes lead to a rise in the number of pregnancies and parenthood in people with CF. This article highlights: (1) Health considerations for people with CF related to pregnancy, contraception, and parenthood. (2) Facets of reproductive planning, fertility, and preconception counseling. (3) Relationship-centered reproductive health discussions.
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Affiliation(s)
- Lauren N Meiss
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, 20 York Street, New Haven, CT 06510, USA
| | - Raksha Jain
- Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8558, USA
| | - Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Center for Innovative Research on Gender Health Equity (CONVERGE), University of Pittsburgh, Pittsburgh, PA, USA.
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Bray LA, Campbell CM, Brown J, Ladores S. Paths to Motherhood for Women with Cystic Fibrosis. MCN Am J Matern Child Nurs 2022; 47:147-153. [PMID: 35475925 DOI: 10.1097/nmc.0000000000000812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Cystic fibrosis (CF) is no longer a disease limited to childhood. With medical advancements, many of those with CF live into adulthood and have similar life goals as their non-CF peers. Most women with CF want to become mothers. However, available options and the related decision-making process is not well understood. The purpose of this study was to explore the decision-making framework of women with CF to better understand the factors they consider when deciding on a path to motherhood. STUDY DESIGN AND METHODS Qualitative interviews were performed using a grounded theory approach. Inclusion criteria were women with CF who became mothers through biological pregnancy, adoption, or gestational surrogacy. Results: Twenty-five mothers with CF were interviewed. A distinct decision-making process was identified through which women started with a desire for motherhood, assessed several factors, then eventually took the path they felt was right for them and their family. CLINICAL IMPLICATIONS Our findings provide women with CF a framework that other women with CF have used to assist in making decisions about their reproductive options. Conversations about family planning should occur early and regularly between women with CF and their health care providers. The decision-making process to achieve motherhood for women with a chronic illness, such as CF, includes consideration of unique factors that should be included in clinical conversations.
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Kazmerski TM, Jain R, Lee M, Taylor-Cousar JL. Parenthood impacts short-term health outcomes in people with cystic fibrosis. J Cyst Fibros 2022; 21:662-668. [PMID: 35181269 DOI: 10.1016/j.jcf.2022.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/19/2022] [Accepted: 02/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with cystic fibrosis (CF) are living longer, healthier lives. A growing number are considering parenthood. There is a substantial knowledge gap regarding the health impacts of parenthood on people with CF. METHODS Using data from the United Kingdom CF registry from 2015 to 2019, we evaluated the impact of having a child on percent predicted forced expiratory volume in 1 second (ppFEV1), body mass index (BMI), and pulmonary exacerbations via multivariable longitudinal data analysis adjusting for age and sex in the year before a person with CF became a parent to the first year following parenthood. We examined whether changes from pre- to post-parenthood differed by sex or CF transmembrane conductance regulator (CFTR) modulator use. RESULTS Among 296 people with CF who became parents, we found a significant decrease in ppFEV1, (adjusted mean difference -3.19, CI: -4.31, -2.07; p<0.01) and BMI (adjusted mean difference -0.28, CI: -0.51, -0.05; p<0.02) and a significant increase in pulmonary exacerbations (adjusted rate ratio 1.3, CI: 1.13, 1.49; p<0.01) in the year following the birth of a child compared to the year prior. Further analysis showed that CFTR modulator use mitigated parenthood impacts on ppFEV1, but not on BMI and pulmonary exacerbations. Females experienced significantly worse impacts on BMI from pre- to post-parenthood compared to males. CONCLUSIONS Parenthood adversely impacts short-term health outcomes for people with CF and CFTR modulator use mitigates such effects. To better understand the impact of the widespread use of highly effective CFTR modulators, longer-term, prospective parenthood studies are needed.
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Affiliation(s)
- Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Center for Women's Health Research and Innovation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Raksha Jain
- Internal Medicine, Pulmonary and Critical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - MinJae Lee
- Division of Biostatistics, Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Kazmerski TM, West NE, Jain R, Uluer A, Georgiopoulos AM, Aitken ML, Taylor-Cousar JL. Family-building and parenting considerations for people with cystic fibrosis. Pediatr Pulmonol 2022; 57 Suppl 1:S75-S88. [PMID: 34407321 PMCID: PMC9292426 DOI: 10.1002/ppul.25620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 01/24/2023]
Abstract
As people with cystic fibrosis (CF) live longer and healthier lives, increasing numbers are considering the full range of reproductive options for their futures, including parenthood, pregnancy, or pregnancy prevention. As the face of CF changes, the CF care model must adapt to meet the reproductive health needs of both parents and nonparents with CF. This article summarizes the reproductive goals and family-building concerns faced by people with CF, including fertility, pregnancy, and alternative paths to parenthood, the impact of parenthood on mental and physical health, and important future research.
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Affiliation(s)
- Traci M Kazmerski
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Natalie E West
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Raksha Jain
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ahmet Uluer
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anna M Georgiopoulos
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Moira L Aitken
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Williams C, Johnson B, Middleton PG, Backer V, Gibson PG, Hollis G, Coleman C. Family planning, pregnancy and birth in women with lung conditions: a worldwide survey. ERJ Open Res 2021; 7:00357-2021. [PMID: 34938801 PMCID: PMC8685512 DOI: 10.1183/23120541.00357-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
Lung diseases can complicate pregnancy, but little is known about the experiences of pregnancy among women living with such diseases. This survey aimed to understand the experiences of women with a lung condition before and during pregnancy, in childbirth and post-partum. The survey was translated into nine languages and hosted online between March and May 2018. This paper reports on 327 women who had asthma, cystic fibrosis (CF), lymphangioleiomyomatosis (LAM) and sarcoidosis as a sole or primary lung condition. Women with CF and LAM were most likely to report that their condition influenced their decision to have children. Those with CF and LAM who did become pregnant reported greater satisfaction with their healthcare during pregnancy and gave more consideration to factors such as location and type of birth; they were also more concerned about the impact of the pregnancy on their health than women with other diseases. Women with sarcoidosis reported receiving conflicting advice as to both the impact of their condition on pregnancy and how becoming pregnant might impact their health. Women with asthma reported not always being able to access the information they needed from healthcare professionals. The results suggest that healthcare providers should be having dialogues with affected women early on, from before conception, throughout the pregnancy and after giving birth, and training should be provided to healthcare staff to equip them with the information they need to do this. This survey found that having a lung condition can play a significant role in women's decisions around family planning, pregnancy and birth. Women wanted more specialist support and better information before, during and after pregnancy.https://bit.ly/3CSpHt9
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Affiliation(s)
| | | | - Peter G Middleton
- CF Research Group, Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, University of Sydney, Sydney, Australia
| | - Vibeke Backer
- Department of ENT and CFAS, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Peter G Gibson
- Centre for Asthma and Respiratory Diseases, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Abstract
Women with cystic fibrosis (CF) face several unaddressed concerns related to their health. These areas of concern include explanations and guidance on a sex disparity in outcomes, timing of puberty, effects of contraception, prevalence of infertility and impact of pregnancy, and prevention of urinary incontinence and osteoporosis. These understudied topics leave women with numerous unanswered questions about how to manage sexual and reproductive health in the setting of CF. Because people with CF are living longer and healthier lives, there is an increasing awareness of these important aspects of care and multiple ongoing studies to address these understudied topics.
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