Common Variable Immune Deficiency and Pregnancy: Improving Outcomes Through Multidisciplinary Care

Area of Science:

• Immunology
• Obstetrics
• Reproductive Medicine

Background:

• Common Variable Immune Deficiency (CVID) poses unique immunological and obstetrical challenges during pregnancy.
• Limited data from case reports and series exist, highlighting the need for standardized management guidelines.
• Optimizing maternal and fetal outcomes necessitates a structured approach to care for pregnant individuals with CVID.

Purpose of the Study:

• To review existing literature on pregnancy outcomes and management strategies for women with CVID.
• To add clinical data through a retrospective chart review of pregnant women with CVID.
• To develop a framework for managing CVID pregnancies.

Main Methods:

• Conducted a narrative literature review with a structured search.
• Performed a 10-year retrospective chart review of pregnant women with CVID at a single institution.
• Synthesized findings to inform management strategies and identify knowledge gaps.

Main Results:

• Pre-conception planning, regular IgG monitoring, and adjusted immunoglobulin replacement therapy (IgRT) improve pregnancy outcomes.
• Proactive management of complications and multidisciplinary care are crucial.
• Subcutaneous immunoglobulin may provide better IgG level stability and flexibility.

Conclusions:

• Many CVID patients can achieve favorable maternal and neonatal outcomes with IgRT and coordinated multidisciplinary care.
• A stepwise multidisciplinary framework is proposed for managing CVID pregnancies.
• Further research is needed to address knowledge gaps in CVID pregnancy management.