TOPLINE:

The introduction of elexacaftor/tezacaftor/ivacaftor (ETI), a triple-combination cystic fibrosis (CF) transmembrane conductance regulator modulator drug, improved maternal and neonatal outcomes in women with CF cared for in a large, dedicated CF maternal health service in London.

METHODOLOGY:

• Researchers conducted a retrospective review of maternal and neonatal outcomes in women with CF from a maternal health service in the UK after the introduction of ETI therapy between September 2020 and February 2025.
• The analysis included 53 women (median age at conception, 30 years) with CF who completed 67 pregnancies resulting in 69 live births.
• The majority (81%) of women with CF had exposure to ETI therapy at any point during pregnancy.
• Data collection encompassed maternal demographics, CF genotype, lung function, pregnancy complications, hospitalisation, and neonatal outcomes.

TAKEAWAY:

• No maternal deaths or ICU admissions were reported, and miscarriage rates did not exceed national rates in the UK. Overall, 31% of pregnancies required hospital admission for infective pulmonary exacerbations, and 57% of women without preexisting CF-related diabetes developed gestational diabetes.
• Overall, 45% of pregnancies resulted in vaginal delivery; 78% of infants were born at term and 22% were born preterm, including 4% of those born early preterm (mean gestational age, < 34 weeks). Around 7% of infants were large for gestational age.
• Congenital anomalies occurred in 4.3% of infants; 22% were admitted to the NICU. No stillbirths or neonatal deaths were reported.

IN PRACTICE:

"This study confirms the significant rise in CF-pregnancies and provides reassuring data of positive outcomes for both fwCF [females with CF] and infants in the ETI-era," the authors wrote.

"fwCF and their healthcare professionals should appreciate that a third of women may experience at least one pulmonary exacerbation during pregnancy that will require hospital admission warranting intravenous antibiotics and focused respiratory physiotherapy," they added.

SOURCE:

This study was led by Rebecca Scott, Chelsea and Westminster Hospital, London, England. It was published online on November 10, 2025, in BJOG: An International Journal of Obstetrics & Gynaecology.

LIMITATIONS:

Findings of this study were from a single large adult CF centre. The quality of the data was limited by the retrospective nature of the study. Only major congenital anomalies detected on routine screening and newborn baby checks were recorded.

DISCLOSURES:

This study was supported by the Royal Brompton and Harefield Hospitals Charity and King's Health Partners Clinical & Academic Innovation Fund. Some authors reported receiving grants, honoraria for presentations and educational activities, speaker fees from speakers bureaus, and advisory fees from various organisations.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.