Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Via Montpellier, 00133, Rome, Italy.
Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.
Neurol Sci. 2024 Feb;45(2):591-599. doi: 10.1007/s10072-023-07029-8. Epub 2023 Sep 2.
As the most common cause of autosomal recessive early onset Parkinson's disease (EOPD), parkin type Parkinson's disease (PRKN-PD) may affect female patients in childbearing age. Accordingly, issues related to fertility must be adequately addressed. Here, we landscaped fertile life factors and pregnancy course of a PRKN-PD cohort, including both novel cases directly observed at our center and published ones.
Six patients with confirmed PRKN-PD were examined by a structured interview on reproductive factors and associated modifications of PD disturbances, including one case followed up throughout pregnancy which was described in greater detail. Six studies reporting fertile life factors of nine PRKN-PD patients were reviewed collecting homogeneous data on fertile life and pregnancy course.
PRKN-PD female patients experienced motor fluctuations with the menstrual cycle, pregnancy, and puerperium, which suggests a role for sex hormones in PD clinical burden. In some cases, abortion and miscarriages occurred during the organogenesis phase in patients receiving oral antiparkinsonian therapy; however, levodopa/benserazide monotherapy resulted to be the safest choice in pregnancy.
Collectively these data disclose the importance of pre-conception counseling in childbearing age PRKN-PD patients and EOPD in general.
作为常染色体隐性早发性帕金森病（EOPD）的最常见病因，parkin 型帕金森病（PRKN-PD）可能会影响到育龄期的女性患者。因此，必须充分解决与生育能力相关的问题。在此，我们对 PRKN-PD 患者的生育因素和妊娠过程进行了分析，包括我们中心直接观察到的新病例和已发表的病例。
对 6 名确诊的 PRKN-PD 患者进行了一项关于生殖因素以及 PD 障碍相关变化的结构性访谈，其中包括一位在整个孕期接受随访的病例，并对其进行了更详细的描述。我们还回顾了 6 项报告了 9 名 PRKN-PD 患者生育因素的研究，收集了关于生育和妊娠过程的同质数据。
PRKN-PD 女性患者在月经周期、妊娠和产褥期出现运动波动，这表明性激素在 PD 临床负担中起作用。在某些情况下，接受口服抗帕金森病药物治疗的患者在器官发生阶段发生了流产和流产；然而，左旋多巴/卡比多巴单药治疗在妊娠期间是最安全的选择。
这些数据共同揭示了在 PRKN-PD 育龄期患者和 EOPD 中进行孕前咨询的重要性。
