High incidence of perinatal insult in children with idiopathic hypopituitarism.

The perinatal histories of 46 children with idiopathic hypopituitarism were assessed in order to define the relationship between perinatal insult and the development of hypopituitarism. Compared to normal control siblings, the pregnancies resulting in hypopituitary children were complicated by a significantly higher incidence of vaginal bleeding at various times during gestation (13 pregnancies). Twenty-four percent of the hypopituitary children were delivered by breech, three times the incidence of control siblings and seven times the incidence of breech deliverery in the general population. Prolonged or unusually short labors were more common in the hypopituitary children (13 patients), as were signs of intrapartum distress and asphyxia (10 patients). At the time of the study, 19 hypopituitary children had neurologic abnormalities; of these, 15 had histories of significant perinatal insult. The findings in this study suggest that, in many cases, perinatal insults may cause hypopituitarism.