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一项评估卡麦角林诱导泌乳素瘤患者妊娠的巴西多中心研究。

A Brazilian multicentre study evaluating pregnancies induced by cabergoline in patients harboring prolactinomas.

机构信息

Division of Endocrinology and Metabolism, Hospital das Clinicas, Neuroendocrine Unit, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, no 155, 8° andar, bloco 3 (Endocrinologia), Sao Paulo, SP, 05403-000, Brazil.

Division of Neurosurgery, Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil.

出版信息

Pituitary. 2020 Apr;23(2):120-128. doi: 10.1007/s11102-019-01008-z.

Abstract

OBJECTIVE

To evaluate the maternal-fetal outcomes of CAB-induced pregnancies in patients with prolactinoma in a large cohort.

METHODS

The prevalence of tumor growth, miscarriage, preterm, low birth weight, congenital malformations and impairment in neuropsychological development in children among women treated with CAB were assessed in a Brazilian multicentre retrospective observational study, RESULTS: We included 194 women with a mean age of 31 (17-45) years, 43.6% presenting microadenomas and 56.4% macroadenomas, at prolactinoma diagnosis. In 233 pregnancies, CAB was withdrawn in 89%, after pregnancy confirmation. Symptoms related to tumor growth occurred in 25 cases, more frequently in macroadenomas. The overall miscarriage rate was 11%, although higher in the subgroup of patients with CAB maintainance after pregnancy confirmation (38% vs. 7.5%). Amongst the live-birth deliveries, preterm occurred in 12%, low birth weight in 6% and congenital malformations in 4.3%. Neuropsychological development impairment was reported in 7% of cases.

CONCLUSIONS

Our findings confirm previous results of safety in maternal and fetal outcomes in CAB-induced pregnancies; nevertheless, CAB maintenance after pregnancy confirmation was associated with higher miscarriage rate; result that must be further confirmed.

摘要

目的

在一项大型队列研究中评估 CAB 诱导妊娠的泌乳素瘤患者的母婴结局。

方法

在巴西一项多中心回顾性观察研究中,评估了接受 CAB 治疗的女性中肿瘤生长、流产、早产、低出生体重、先天性畸形和儿童神经心理发育障碍的发生率。

结果

我们纳入了 194 名平均年龄为 31 岁(17-45 岁)的女性,其中 43.6%为微腺瘤,56.4%为大腺瘤。在 233 例妊娠中,89%在妊娠确认后停用了 CAB。25 例出现与肿瘤生长相关的症状,大腺瘤中更常见。总的流产率为 11%,但在妊娠确认后继续维持 CAB 的患者亚组中更高(38%比 7.5%)。在活产分娩中,早产发生率为 12%,低出生体重发生率为 6%,先天性畸形发生率为 4.3%。报告了 7%的病例存在神经心理发育障碍。

结论

我们的发现证实了 CAB 诱导妊娠的母婴结局安全性的先前结果;然而,妊娠确认后继续维持 CAB 与更高的流产率相关;这一结果需要进一步证实。

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