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Fertility, pregnancies and outcomes reported by females with common variable immune deficiency and hypogammaglobulinemia: results from an internet-based survey.

Gundlapalli AV, Scalchunes C, Boyle M, Hill HR - J. Clin. Immunol. (2015)

Bottom Line: This group reported a total of 966 pregnancies; 72 % resulted in a live birth.A majority of the pregnancies progressed with no incident and with continuation of their IgG replacement therapy; 23 % reported an increase in IgG dosing during pregnancy.Results of the survey will serve as peer support for patients and inform counseling guidelines for providers.

View Article: PubMed Central - PubMed

Affiliation: Departments of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA, adi.gundlapalli@hsc.utah.edu.

ABSTRACT

Background: Issues of fertility and pregnancy place an extra burden on females with primary immunodeficiencies. Patients lack reliable information and providers lack guidelines to counsel patients on these anxiety-provoking matters.

Objective: To collate concerns and experiences related to fertility and pregnancy from females with humoral immune deficiencies.

Methods: We conducted an internet-based survey of female patients who self-identified as having a diagnosis of primary humoral immune deficiency.

Results: Responses from 490 women with common variable immune deficiency and 100 with hypogammaglobulinemia were evaluated. The reported fertility measure (% of women who had had a birth) was statistically significantly lower as compared to the general US population (70 % vs. 85 %, p < 0.0001) whereas the rates of spontaneous pregnancy loss were comparable. This group reported a total of 966 pregnancies; 72 % resulted in a live birth. A majority of the pregnancies progressed with no incident and with continuation of their IgG replacement therapy; 23 % reported an increase in IgG dosing during pregnancy. Only 15 % of those reporting a first pregnancy indicated that they had been diagnosed with immune deficiency prior to their first pregnancy; these women expressed concern regarding the effect of immune deficiency on their fertility, pregnancy and decision to have children.

Conclusion: With inherent limitations of self-reported responses to surveys, females with humoral immune deficiencies reported relatively good rates of fertility and pregnancies ending in live births. Results of the survey will serve as peer support for patients and inform counseling guidelines for providers.

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Related in: MedlinePlus

Reported selected concerns and outcomes of first through fifth pregnancies of females with common variable immune deficiency and hypogammaglobulinemia; Results of 939 pregnancies reported for these questions
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Fig1: Reported selected concerns and outcomes of first through fifth pregnancies of females with common variable immune deficiency and hypogammaglobulinemia; Results of 939 pregnancies reported for these questions

Mentions: In reviewing responses for those reporting 1 through 5 pregnancies (Fig. 1), the average years since those pregnancies was between 24 and 29 years ago. Fifteen percent reported a diagnosis of PI prior to their first pregnancy; there was an upward trend in those diagnosed with PI prior to subsequent pregnancies (30 %). There was also an increasing trend in their concern about losing the pregnancy (from 37 to 66 %) from first to subsequent pregnancies. Conversely, concerns regarding the pregnancy endangering their health and their children getting PI were lower with subsequent pregnancies.Fig. 1


Fertility, pregnancies and outcomes reported by females with common variable immune deficiency and hypogammaglobulinemia: results from an internet-based survey.

Gundlapalli AV, Scalchunes C, Boyle M, Hill HR - J. Clin. Immunol. (2015)

Reported selected concerns and outcomes of first through fifth pregnancies of females with common variable immune deficiency and hypogammaglobulinemia; Results of 939 pregnancies reported for these questions
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352195&req=5

Fig1: Reported selected concerns and outcomes of first through fifth pregnancies of females with common variable immune deficiency and hypogammaglobulinemia; Results of 939 pregnancies reported for these questions
Mentions: In reviewing responses for those reporting 1 through 5 pregnancies (Fig. 1), the average years since those pregnancies was between 24 and 29 years ago. Fifteen percent reported a diagnosis of PI prior to their first pregnancy; there was an upward trend in those diagnosed with PI prior to subsequent pregnancies (30 %). There was also an increasing trend in their concern about losing the pregnancy (from 37 to 66 %) from first to subsequent pregnancies. Conversely, concerns regarding the pregnancy endangering their health and their children getting PI were lower with subsequent pregnancies.Fig. 1

Bottom Line: This group reported a total of 966 pregnancies; 72 % resulted in a live birth.A majority of the pregnancies progressed with no incident and with continuation of their IgG replacement therapy; 23 % reported an increase in IgG dosing during pregnancy.Results of the survey will serve as peer support for patients and inform counseling guidelines for providers.

View Article: PubMed Central - PubMed

Affiliation: Departments of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, 84132, USA, adi.gundlapalli@hsc.utah.edu.

ABSTRACT

Background: Issues of fertility and pregnancy place an extra burden on females with primary immunodeficiencies. Patients lack reliable information and providers lack guidelines to counsel patients on these anxiety-provoking matters.

Objective: To collate concerns and experiences related to fertility and pregnancy from females with humoral immune deficiencies.

Methods: We conducted an internet-based survey of female patients who self-identified as having a diagnosis of primary humoral immune deficiency.

Results: Responses from 490 women with common variable immune deficiency and 100 with hypogammaglobulinemia were evaluated. The reported fertility measure (% of women who had had a birth) was statistically significantly lower as compared to the general US population (70 % vs. 85 %, p < 0.0001) whereas the rates of spontaneous pregnancy loss were comparable. This group reported a total of 966 pregnancies; 72 % resulted in a live birth. A majority of the pregnancies progressed with no incident and with continuation of their IgG replacement therapy; 23 % reported an increase in IgG dosing during pregnancy. Only 15 % of those reporting a first pregnancy indicated that they had been diagnosed with immune deficiency prior to their first pregnancy; these women expressed concern regarding the effect of immune deficiency on their fertility, pregnancy and decision to have children.

Conclusion: With inherent limitations of self-reported responses to surveys, females with humoral immune deficiencies reported relatively good rates of fertility and pregnancies ending in live births. Results of the survey will serve as peer support for patients and inform counseling guidelines for providers.

Show MeSH
Related in: MedlinePlus