PDF(Pubmed)
Abstract：
OBJECTIVE: Prolactin (PRL)-secreting tumours are associated with infertility and can be reverted by dopamine agonist (DA) therapy. The suspension of DA is recommended once pregnancy is established, as all DAs cross the placenta. The aim of the study was to evaluate the rate of maternal-foetal complications in women treated with cabergoline (CAB) or bromocriptine (BRM) for prolactinoma during gestation and the effect of pregnancy on prolactinoma progression.
METHODS: This was a retrospective observational study involving 43 women affected by prolactinoma who became pregnant during therapy with CAB or BRM for a total of 58 pregnancies. For each patient, medical records were analysed by integrating the data with outpatient or telephone interview.
RESULTS: At the time of conception, 18 women were in the BRM group, while 40 were in CAB group. No differences were found in obstetric or neonatal outcomes between the two groups. There was a significant difference (p = 0.046) in child complications reported in maternal interview found exclusively in the CAB group. No further confounding factors were detected. Disease remission rate after the first pregnancy was 42.9% and the main predictor was a lower PRL nadir before pregnancy (p = 0.023). No difference was detected between the two groups in terms of tumor remission. Breastfeeding did not modify the outcome.
CONCLUSIONS: Foetal exposure to DAs during the first weeks of embryogenesis is not associated with a greater risk of complications. The transient and mild developmental disorders recorded resolved spontaneously and the prevalence was substantially overlapping with that observed in the general population.
METHODS: This was a retrospective observational study involving 43 women affected by prolactinoma who became pregnant during therapy with CAB or BRM for a total of 58 pregnancies. For each patient, medical records were analysed by integrating the data with outpatient or telephone interview.
RESULTS: At the time of conception, 18 women were in the BRM group, while 40 were in CAB group. No differences were found in obstetric or neonatal outcomes between the two groups. There was a significant difference (p = 0.046) in child complications reported in maternal interview found exclusively in the CAB group. No further confounding factors were detected. Disease remission rate after the first pregnancy was 42.9% and the main predictor was a lower PRL nadir before pregnancy (p = 0.023). No difference was detected between the two groups in terms of tumor remission. Breastfeeding did not modify the outcome.
CONCLUSIONS: Foetal exposure to DAs during the first weeks of embryogenesis is not associated with a greater risk of complications. The transient and mild developmental disorders recorded resolved spontaneously and the prevalence was substantially overlapping with that observed in the general population.
摘要：
目的：分泌催乳素（PRL）的肿瘤与不孕症有关，可以通过多巴胺激动剂（DA）治疗逆转。一旦怀孕确定，建议暂停DA，当所有的数据都穿过胎盘时。该研究的目的是评估妊娠期间用卡麦角林（CAB）或溴隐亭（BRM）治疗泌乳素瘤的妇女的母婴并发症发生率以及妊娠对泌乳素瘤进展的影响。
方法：这是一项回顾性观察性研究，涉及43名患有泌乳素腺瘤的妇女，她们在接受CAB或BRM治疗期间怀孕，共58次怀孕。对于每个病人来说,通过将数据与门诊或电话访谈相结合来分析医疗记录.
结果：在受孕时，BRM组有18名女性，CAB组40人。两组在产科或新生儿结局方面没有差异。仅在CAB组中发现的产妇访谈中报告的儿童并发症存在显着差异（p=0.046）。没有检测到进一步的混杂因素。首次妊娠后疾病缓解率为42.9％，主要预测因素是妊娠前PRL最低点较低（p=0.023）。在肿瘤缓解方面，两组之间没有发现差异。母乳喂养并没有改变结果。
结论：胎儿在胚胎发生的头几周内暴露于DAs与更大的并发症风险无关。记录的短暂和轻度发育障碍自发解决，患病率与普通人群中观察到的患病率基本重叠。
方法：这是一项回顾性观察性研究，涉及43名患有泌乳素腺瘤的妇女，她们在接受CAB或BRM治疗期间怀孕，共58次怀孕。对于每个病人来说,通过将数据与门诊或电话访谈相结合来分析医疗记录.
结果：在受孕时，BRM组有18名女性，CAB组40人。两组在产科或新生儿结局方面没有差异。仅在CAB组中发现的产妇访谈中报告的儿童并发症存在显着差异（p=0.046）。没有检测到进一步的混杂因素。首次妊娠后疾病缓解率为42.9％，主要预测因素是妊娠前PRL最低点较低（p=0.023）。在肿瘤缓解方面，两组之间没有发现差异。母乳喂养并没有改变结果。
结论：胎儿在胚胎发生的头几周内暴露于DAs与更大的并发症风险无关。记录的短暂和轻度发育障碍自发解决，患病率与普通人群中观察到的患病率基本重叠。
