Chest · 2026
Fertility, pregnancy, and women's health in bronchiectasis: a multicenter study and ELF-EMBARC patient survey.
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Boehm-Cohen Liora, Pollock Jennifer, Kompatsiari Eliza, Blumenfeld Zeev, Raviv Yael, McGill Rachael, Kassirer Michael, Boyd Jeanette, Elraz Lior, Heilweil Donna, Traversi Letizia, Polverino Eva, Kuusisto Anu, Sibila Oriol, Ringshausen Felix C, Rademacher Jessica, Goeminne Pieter, Middleton Peter G, Wand Ori, Lorent Natalie, Heching Moshe, Kuint Rottem, Azmanov Henny, Gramegna Andrea, Blasi Francesco, Cymberknoh Malena Cohen, Aliberti Stefano, Stein Nili, Chalmers James D, Shteinberg Michal
Аннотация
BACKGROUND: Bronchiectasis in women of reproductive age is increasingly recognized, yet data on fertility and pregnancy outcomes remain limited.
RESEARCH QUESTION: What are fertility characteristics, pregnancy outcomes, and patient-reported reproductive health experiences in women with bronchiectasis?
STUDY DESIGN AND METHODS: We conducted a multicenter, retrospective cohort study across EMBARC-affiliated centers including women with bronchiectasis and pregnancy between 2012 and 2023. Clinical, pulmonary, obstetric, and neonatal data were collected. In parallel, an international patient survey assessed fertility, pregnancy, and hormonal influences on disease. Statistical analyses included comparative and correlation testing.
RESULTS: Eighty-three women contributed data from 121 pregnancies and 123 neonates. Mean age at conception was 29.5 years. Assisted reproductive technologies were used in 32.1% of pregnancies, more frequently in primary ciliary dyskinesia (PCD) than other etiologies (48.5% vs. 8.7%, P=0.004). Lung function remained stable during and after pregnancy. Exacerbations occurred in 58.6% of pregnancies. Mean gestational age was 38 weeks and mean birth weight was 2.99 kg. Pre-pregnancy FEV1 correlated with birth weight (ρ=0.42, P=0.001) and gestational age (ρ=0.25, P=0.042). Neonatal outcomes were generally favorable. Survey data (n=629) demonstrated an early onset of menopause in women with bronchiectasis diagnosed before age 50 years compared to after 50 years. Women with PCD reported difficulties conceiving more often than women with early onset bronchiectasis without PCD.
INTERPRETATION: Pregnancy in women with bronchiectasis is frequently complicated by exacerbations and low neonatal birth weight. Subfertility is primarily driven by PCD, while non-PCD bronchiectasis shows rates similar to the general population. Pre-pregnancy lung function is associated with neonatal outcomes, supporting the importance of pulmonary optimization and multidisciplinary care before and during pregnancy.
RESEARCH QUESTION: What are fertility characteristics, pregnancy outcomes, and patient-reported reproductive health experiences in women with bronchiectasis?
STUDY DESIGN AND METHODS: We conducted a multicenter, retrospective cohort study across EMBARC-affiliated centers including women with bronchiectasis and pregnancy between 2012 and 2023. Clinical, pulmonary, obstetric, and neonatal data were collected. In parallel, an international patient survey assessed fertility, pregnancy, and hormonal influences on disease. Statistical analyses included comparative and correlation testing.
RESULTS: Eighty-three women contributed data from 121 pregnancies and 123 neonates. Mean age at conception was 29.5 years. Assisted reproductive technologies were used in 32.1% of pregnancies, more frequently in primary ciliary dyskinesia (PCD) than other etiologies (48.5% vs. 8.7%, P=0.004). Lung function remained stable during and after pregnancy. Exacerbations occurred in 58.6% of pregnancies. Mean gestational age was 38 weeks and mean birth weight was 2.99 kg. Pre-pregnancy FEV1 correlated with birth weight (ρ=0.42, P=0.001) and gestational age (ρ=0.25, P=0.042). Neonatal outcomes were generally favorable. Survey data (n=629) demonstrated an early onset of menopause in women with bronchiectasis diagnosed before age 50 years compared to after 50 years. Women with PCD reported difficulties conceiving more often than women with early onset bronchiectasis without PCD.
INTERPRETATION: Pregnancy in women with bronchiectasis is frequently complicated by exacerbations and low neonatal birth weight. Subfertility is primarily driven by PCD, while non-PCD bronchiectasis shows rates similar to the general population. Pre-pregnancy lung function is associated with neonatal outcomes, supporting the importance of pulmonary optimization and multidisciplinary care before and during pregnancy.