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.
Pituitary. 2020 Apr;23(2):120-128. doi: 10.1007/s11102-019-01008-z.
To evaluate the maternal-fetal outcomes of CAB-induced pregnancies in patients with prolactinoma in a large cohort.
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 In 233 pregnancies, CAB was withdrawn in 89%, after pregnancy confirmation.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.
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.
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。
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。
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。
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。