Pregnancy and lactation in patients with common variable immunodeficiency: a single center experience

Common variable immunodeficiency (CVID) is a primary antibody deficiency characterized by hypogammaglobulinemia and recurrent infections. Studies on the effects of CVID in pregnant patients are still needed. We aimed to investigate the effects of CVID on pregnancy outcomes and newborns.

We retrospectively evaluated 33 women with CVID and 94 pregnant women at our center. Patients were assessed based on infection rates, pregnancy complications, and use of immunoglobulin replacement therapy (IgRT) in both preterm and post-term periods. Patient data were collected from hospital databases and medical records.

The mean age at first pregnancy was 24.7 (17-45) years, with an average of 2.8 pregnancies per woman. CVID was detected before pregnancy in 24.2% of cases, and 24.2% of patients initiated IgRT during pregnancy. The live birth rate was 69.1%, while early fetal loss occurred in 27.7% of pregnancies, and stillbirth in 3.2%. Infection-related complications occurred in 18% of pregnancies and 14.9% of postpartum periods. The most common infections were upper respiratory and urinary tract infections. Parenteral antibiotic treatment was required for patients who did not receive IgRT during pregnancy. Neonatal infections were observed in 6.6% of cases, and the admission rate to the neonatal intensive care unit was 5.5%.

Our study emphasizes that live birth and fetal loss rates in patients with CVID are comparable to those in the general population. Informing patients of the potential risks associated with consanguinity is crucial. Moreover, given the increased vulnerability of patients with CVID to infections, extra precautions are needed during pregnancy and the postpartum period.