Disease activity and maternal-fetal outcomes in pregnant women with prolactinoma: A systematic review and meta-analysis.

Autor:	Bandeira DB; Department of Internal Medicine, São Paulo State University (UNESP), Medical School, Botucatu, São Paulo, Brazil., Alves LS; Department of Internal Medicine, São Paulo State University (UNESP), Medical School, Botucatu, São Paulo, Brazil., Glezer A; Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of Sao Paulo Medical School, São Paulo, Brazil., Boguszewski CL; Endocrine Division (SEMPR), Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil., Dos Santos Nunes-Nogueira V; Department of Internal Medicine, São Paulo State University (UNESP), Medical School, Botucatu, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2024 Nov 25. Date of Electronic Publication: 2024 Nov 25.
DOI:	10.1210/clinem/dgae821
Abstrakt:	Context: Women with prolactinoma are usually infertile, but can conceive after surgery or treatment with dopamine agonists (DA). Objective: To evaluate the impact of pregnancy in prolactinoma's natural course and in maternal-fetal outcomes. Data Sources: MEDLINE, EMBASE, LILACS, and CENTRAL. Study Selection: Observational studies that included at least three pregnant women with prolactinoma. Data Extraction: Two independent reviewers selected studies, assessed the risk of bias, and extracted data from the included studies. Data Synthesis: Fifty-two studies were included, involving 2544 pregnancies in 1928 women. The Stata Statistical Software 18 was used for proportional meta-analyses. The overall frequency of pregnant women on DA treatment at conception was 97% and for either continuing or resuming treatment during pregnancy was 6%. The overall frequency of miscarriage was 10% (95% confidence interval [CI], 8%-12%), 3% for prematurity (95% CI, 2%-5%), 4% for symptomatic tumor growth during pregnancy (95% CI, 2%-8%), 4% for visual impairment (95% CI, 2%-7%), 6% for headache (95% CI, 4%-9%), and 4% for development of gestational diabetes (95% CI, 3%-7%). The overall frequency of congenital malformations was 2% (95% CI, 1%-4%), 2% for perinatal mortality (95% CI, 1%-2%), and 6% for low birth weight (95% CI, 3%-9%). Moreover, prolactinoma's size is a significant modifier for visual impairment. Conclusion: Pregnancy in women with prolactinoma is safe in relation to fetal and maternal outcomes with low frequencies of miscarriage, prematurity, symptomatic growth, visual impairment, headache, congenital malformations, perinatal mortality, and low birth weight. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. See the journal About page for additional terms.)
Databáze:	MEDLINE
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