E-Mail karger@karger.com Review Respiration 2016;91:333–348 DOI: 10.1159/000444088 Safety of Drugs during Pregnancy and Breastfeeding in Cystic Fibrosis Patients Alice Panchaud a Ermindo R. Di Paolo b Angela Koutsokera c Ursula Winterfeld d Etienne Weisskopf a David Baud e Alain Sauty c Chantal Csajka a a School of Pharmaceutical Sciences, University of Geneva and University of Lausanne, Geneva, b Service of Pharmacy, Department of Laboratory, c Service of Pneumology, Department of Medicine, d STIS and Division of Clinical Pharmacology, and e Materno-Fetal and Obstetrics Research Unit, Department of Gynecology and Obstetrics, University Hospital of Lausanne, Lausanne, Switzerland Introduction Median survival of patients suffering from cystic fibro- sis (CF) has dramatically improved over the last decades, due to treatment and nutrition optimization. With in- creasing life expectancy, more and more women with CF wish to conceive. In contrast to males, the majority of fe- males with CF have near-normal fertility, despite possible ovulation disturbances in patients with more severe dis- ease [1]. About 240 pregnancies in CF patients are reported an- nually to the US Cystic Fibrosis Foundation Registry [2]. Furthermore, data from the US Nationwide Inpatient Sample showed a significant linear increase in the num- ber of women with CF at delivery, going from 2.99 to 9.84 per 100,000 deliveries over the 2000–2010 period [3]. Proposed prognostic markers for pregnancy and fetal outcomes are lung function parameters (before and dur- ing pregnancy), overall nutritional status, CF-related dia- betes and post-lung transplantation status [4–6]. Several studies have reported favorable maternofetal outcomes during and following pregnancy in women with CF, Key Words Cystic fibrosis · Pregnancy · Lactation · Teratogen · Fetal risk Abstract Health management of cystic fibrosis (CF) patients should be maximized during pregnancy and breastfeeding because of its significant impact on the maternal and newborn out- comes. Thus, numerous drugs will have to be continued dur- ing pregnancy and lactation. Most of the drugs representing CF treatment lines cross the placenta or are excreted into human milk. Research addressing the risks and benefits of drugs used in CF patients during pregnancy and lactation is often incomplete or challenged by limited methodology, which often leads to conflicting or inconclusive results. Yet, potential treatment benefits for CF pregnant patients most often outbalance potential risks for the unborn child. © 2016 S. Karger AG, Basel Received: June 8, 2015 Accepted after revision: January 13, 2016 Published online: March 5, 2016 Alice Panchaud, PhD Groupe de Pharmacie hospitalière & clinique, Section des Sciences Pharmaceutiques, Université de Genève, Université de Lausanne Bureau BU/17-01/191, Av. du Bugnon 17, CH–1011 Lausanne (Switzerland) E-Mail alice.panchaud  @  chuv.ch © 2016 S. Karger AG, Basel 0025–7931/16/0914–0333$39.50/0 www.karger.com/res