Emily M Godfrey, Amalia Magaret, Andrea Roe, Jennifer L Taylor-Cousar, Patricia Walker, Elinor Langfelder-Schwind, Traci M Kazmerski, Raksha Jain, Sheila K Mody, Ahmet Uluer, Natalie E West, Leigh Ann Bray, Chialing Hsu, Anna Fiastro, Karen D Hinckley Stukovsky, Dennis Hadjiliadis, George M Solomon, Sigrid Ladores-Barrett
{"title":"Contraceptive use and pregnancy in cystic fibrosis: Survey findings from 10 cystic fibrosis centers.","authors":"Emily M Godfrey, Amalia Magaret, Andrea Roe, Jennifer L Taylor-Cousar, Patricia Walker, Elinor Langfelder-Schwind, Traci M Kazmerski, Raksha Jain, Sheila K Mody, Ahmet Uluer, Natalie E West, Leigh Ann Bray, Chialing Hsu, Anna Fiastro, Karen D Hinckley Stukovsky, Dennis Hadjiliadis, George M Solomon, Sigrid Ladores-Barrett","doi":"10.1016/j.jcf.2025.01.007","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Reproductive life planning is key, now that people with cystic fibrosis (pwCF) may live into their 60s. This study explores contraceptive use, pregnancy trends, and whether concomitant cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy reduces contraceptive effectiveness.</p><p><strong>Methods: </strong>Females with CF aged 18-45 years from 10 U.S. CF centers completed a self-administered web-based questionnaire. Pregnancy rates were calculated by linear-mixed models with a logit link detected associations with contraception and modulator use.</p><p><strong>Results: </strong>A total of 561 pwCF (median age of 29 years [IQR 24.9-35.8] years) completed the survey. Most participants (n = 499, 89%) used modulators, and almost all (n = 555, 99%) used contraception. Condoms (n = 448, 80%) and oral contraceptive pills (n = 363, 65%) were the most prevalent methods used. One-third (n = 189, 34%) reported ever being pregnant. Of those reporting pregnancies (n = 319), about half (n = 151, 48%) were unintended. Pregnancy was significantly associated with age (20-29 years or 30-39 years), partner cohabitation (aOR 21.5, 95% CI 5.1 to 91.1), and non-hormonal contraceptive use (aOR 5.1, 95% CI 1.1 to23.0). Among pwCF cohabitating with a partner, modulator use was positively associated with pregnancy (OR 1.8, 95% CI 1.3 to 2.6) (p = 0.0008).</p><p><strong>Conclusions: </strong>Despite almost universal contraceptive use, unintended pregnancy among pwCF is common. Likelihood of pregnancy is increased among CFTR modulator users who are partnered, although CFTR modulators themselves do not appear to decrease hormonal contraceptive effectiveness. Patient education about contraception is an increasingly critical aspect of CF care.</p>","PeriodicalId":15452,"journal":{"name":"Journal of Cystic Fibrosis","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cystic Fibrosis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jcf.2025.01.007","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Reproductive life planning is key, now that people with cystic fibrosis (pwCF) may live into their 60s. This study explores contraceptive use, pregnancy trends, and whether concomitant cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapy reduces contraceptive effectiveness.
Methods: Females with CF aged 18-45 years from 10 U.S. CF centers completed a self-administered web-based questionnaire. Pregnancy rates were calculated by linear-mixed models with a logit link detected associations with contraception and modulator use.
Results: A total of 561 pwCF (median age of 29 years [IQR 24.9-35.8] years) completed the survey. Most participants (n = 499, 89%) used modulators, and almost all (n = 555, 99%) used contraception. Condoms (n = 448, 80%) and oral contraceptive pills (n = 363, 65%) were the most prevalent methods used. One-third (n = 189, 34%) reported ever being pregnant. Of those reporting pregnancies (n = 319), about half (n = 151, 48%) were unintended. Pregnancy was significantly associated with age (20-29 years or 30-39 years), partner cohabitation (aOR 21.5, 95% CI 5.1 to 91.1), and non-hormonal contraceptive use (aOR 5.1, 95% CI 1.1 to23.0). Among pwCF cohabitating with a partner, modulator use was positively associated with pregnancy (OR 1.8, 95% CI 1.3 to 2.6) (p = 0.0008).
Conclusions: Despite almost universal contraceptive use, unintended pregnancy among pwCF is common. Likelihood of pregnancy is increased among CFTR modulator users who are partnered, although CFTR modulators themselves do not appear to decrease hormonal contraceptive effectiveness. Patient education about contraception is an increasingly critical aspect of CF care.
期刊介绍:
The Journal of Cystic Fibrosis is the official journal of the European Cystic Fibrosis Society. The journal is devoted to promoting the research and treatment of cystic fibrosis. To this end the journal publishes original scientific articles, editorials, case reports, short communications and other information relevant to cystic fibrosis. The journal also publishes news and articles concerning the activities and policies of the ECFS as well as those of other societies related the ECFS.