Department of Pediatrics and Pediatric Hematology/Oncology, University Children's Hospital, Klinikum Oldenburg AöR, Oldenburg, Germany.
Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand.
Neuroendocrinology. 2021;111(1-2):16-26. doi: 10.1159/000506639. Epub 2020 Feb 20.
Data on female fertility, pregnancy, and outcome of offspring after childhood-onset craniopharyngioma (CP) are rare.
Observational study on pregnancy rate and offspring outcome in female CP patients recruited in KRANIOPHARYNGEOM 2000/2007 since 2000.
A total of 451 CP patients (223 female) have been recruited, and 269 (133 female) were postpubertal at study. Six of 133 female CP patients (4.5%) with a median age of 14.9 years at CP diagnosis had 9 pregnancies, giving birth to 10 newborns. Three patients achieved complete surgical resections. No patient underwent postoperative irradiation. Five natural pregnancies occurred in 3 CP patients without pituitary deficiencies. Four pregnancies in 3 CP patients with hypopituitarism were achieved under assisted reproductive techniques (ART) (median 4.5 cycles, range: 3-6 cycles). Median maternal age at pregnancy was 30 years (range: 22-41 years). Six babies (60%) were delivered by caesarean section. Median gestational age at delivery was 38 weeks (range: 34-43 weeks); median birth weight was 2,920 g (range: 2,270-3,520 g), the rate of preterm delivery was 33%. Enlargements of CP cysts occurred in 2 women during pregnancy. Other complications during pregnancy, delivery, and postnatal period were not observed.
Pregnancies after CP are rare and were only achieved after ART in patients with hypopituitarism. Close monitoring by an experienced reproductive physician is necessary. Due to a potentially increased risk for cystic enlargement, clinical, ophthalmological, and MRI monitoring are recommended in patients at risk. Severe perinatal complications, birth defects, and postnatal morbidity of mothers and offspring were not observed.
关于儿童期颅咽管瘤（CP）后女性生育能力、妊娠和后代结局的数据很少。
自 2000 年以来，通过 KRANIOPHARYNGEOM 2000/2007 招募的 CP 女性患者中，观察妊娠率和后代结局。
共招募了 451 例 CP 患者（223 例女性），269 例（133 例女性）在研究时已过青春期。133 例 CP 女性患者中有 6 例（4.5%）患者中位年龄为 14.9 岁，共怀孕 9 次，分娩 10 名新生儿。3 例患者行完全手术切除。无患者术后行放疗。3 例无垂体功能减退的 CP 患者发生 5 例自然妊娠。3 例存在垂体功能减退的 CP 患者行 4 次辅助生殖技术（ART）妊娠（中位 4.5 个周期，范围：3-6 个周期）。妊娠时的中位母亲年龄为 30 岁（范围：22-41 岁）。6 名婴儿（60%）经剖宫产分娩。中位分娩孕周为 38 周（范围：34-43 周）；中位出生体重为 2920 克（范围：2270-3520 克），早产率为 33%。2 例女性在妊娠期间 CP 囊肿增大。未观察到妊娠、分娩和产后期间的其他并发症。
CP 后妊娠罕见，仅在存在垂体功能减退的患者中通过 ART 实现。需要由经验丰富的生殖医生进行密切监测。由于囊性增大的风险增加，建议对有风险的患者进行临床、眼科和 MRI 监测。未观察到严重的围产期并发症、出生缺陷和母婴产后发病率。
