D2.348 - Common Variable Immune Deficiency in Pregnancy: Multidisciplinary Approach to Improving Obstetrical Outcome

Pregnancy presents unique immunological and obstetrical challenges for women with Common Variable Immune Deficiency (CVID), yet no standardized guidelines currently exist to guide management. Establishing a structured approach to care is important to optimize maternal and fetal outcomes.

A systematic review of the literature was performed to guide clinical management recommendations. A retrospective chart review of women with CVID who became pregnant while receiving care at the McGill University Health Centre between 20152025 was conducted. Maternal, obstetrical, immunological, and immediate neonatal outcomes are described. 

Key management principles included trimester-based immunoglobulin (IgRT) dose adjustments, regular monitoring of serum IgG, proactive management of autoimmune or infectious complications, and multidisciplinary coordination. SCIG therapy offered flexibility and stability of IgG levels. 

Favorable pregnancy outcomes are achievable with structured IgRT protocols, regular surveillance, and multidisciplinary management. We propose a practical management algorithm to guide care and inform future prospective studies.