Preconception and prenatal cystic fibrosis (CF) carrier screening should be made available to all women of reproductive age as a routine part of obstetric care, according to a revised Committee Opinion issued by The American College of Obstetricians and Gynecologists. In addition to an update of current guidance for CF screening practices, the document discusses counseling strategies, special reproductive health considerations for women with CF, and clinical management recommendations.

Cystic fibrosis is a progressive, multisystem disease that primarily impacts the lungs, pancreas, and digestive tract. CF significantly shortens the lifespan of people affected by it-median survival is approximately 37 years. Because CF is caused by an inherited genetic mutation, carrier screening is recommended to identify couples at risk for having a child with the disease.

The incidence of CF is highest among non-Hispanic white individuals (roughly 1 in 2,500) and people of Ashkenazi Jewish ancestry. It is considerably less common (but still occurs) in other ethnic groups. The College recommends that CF carrier screening be offered to all women of childbearing age, preferably before conception. Women who are CF carriers and their reproductive partners may need additional screening tests and referrals for genetic and reproductive counseling.

The College also recommends contraception and preconception consultation for women with CF who are considering pregnancy. They should be told that their children will be CF carriers and that their partners should also be screened to determine carrier risk. Women with CF who want to become pregnant can work with a multidisciplinary team to manage issues such as pulmonary function, weight gain, infections, and the increased risk of diabetes and preterm delivery.

Committee Opinion #486, "Update on Carrier Screening for Cystic Fibrosis," is published in the April 2011 issue of Obstetrics & Gynecology.

Source:
American College of Obstetricians and Gynecologists