Course and outcomes of pregnancy in women treated for acromegaly: Discerning a contemporary cohort

IF 1.6 4区 医学 Q4 CELL BIOLOGY Growth Hormone & Igf Research Pub Date : 2021-10-01 DOI:10.1016/j.ghir.2021.101417
Liza Das , Pinaki Dutta , Balamurugan Thirunavukkarasu , Kirti Gupta , Manjul Tripathi , Prakamya Gupta , Neelam Aggarwal , Ashutosh Rai , Bishan Dass Radotra , Anil Bhansali , Vanita Suri
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引用次数: 3

Abstract

Objective

To analyze pregnancy course and outcomes in women treated for acromegaly and compare outcomes based on disease activity at the time of conception.

Design

Retrospective study.

Patients

Women with acromegaly diagnosed prior to or during pregnancy from 2010 to 2019, representing cases (14 pregnancies in 12 cases), were later stratified based on active (n = 5) or controlled disease (n = 9) at time of conception. Female acromegalic patients over the same period constituted the ‘acromegaly cohort’ (AC) (n = 75).

Results

All cases had macroadenomas with nadir GH of 15.06 ng/ml (IQR 9–30), IGF-I index of 3.04 (1.96–3.82), for which they had undergone pituitary surgery; except two patients diagnosed during pregnancy, who received pharmacotherapy followed by surgery 4 months postpartum. Adjuvant pharmacotherapy was required in 71.4% patients and radiotherapy in 35.7%. Pregnancy occurred at a median of 2 (0.8–5.1) years after surgery and 21.4% required assisted reproduction. All had term delivery with normal APGAR except one case with gestational hypertension, who delivered a preterm baby. None had congenital malformations. Despite higher baseline IGF-I, GH and tumor volume in those with pre-conceptional active acromegaly, materno-fetal outcomes were not different from those with controlled disease (p > 0.05). Similar or greater proportion of cases had normal GH and no residual tumor postpartum, even in those with pre-conceptional active acromegaly.

Conclusion

The current study showed conducive outcomes of gestation in women treated for acromegaly and no higher rates of pregnancy parameters or complications than non-acromegaly pregnancies in the same population. Active acromegaly does not seem to have an adverse bearing on outcomes.

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肢端肥大症治疗妇女的妊娠过程和结局:辨别当代队列
目的分析肢端肥大症患者的妊娠过程和结局,并比较妊娠时疾病活动性的结局。DesignRetrospective研究。2010年至2019年妊娠前或妊娠期间诊断的肢端肥大症患者(12例中有14例妊娠),随后根据妊娠时的活跃性(n = 5)或控制疾病(n = 9)进行分层。同一时期的女性肢端肥大症患者构成“肢端肥大症队列”(AC) (n = 75)。结果所有大腺瘤患者均行垂体手术,最低GH为15.06 ng/ml (IQR 9-30), IGF-I指数为3.04 (1.96 ~ 3.82);除2例在妊娠期确诊外,均在产后4个月接受药物治疗后手术治疗。71.4%的患者需要辅助药物治疗,35.7%的患者需要放疗。手术后怀孕的中位数为2年(0.8-5.1年),21.4%需要辅助生殖。除1例妊娠期高血压患者早产外,其余均足月分娩,APGAR正常。没有先天性畸形。尽管孕前活动性肢端肥大症患者的基线IGF-I、GH和肿瘤体积较高,但母胎结局与疾病控制的患者没有差异(p >0.05)。类似或更大比例的病例生长激素正常,产后无残留肿瘤,甚至在那些孕前活动性肢端肥大症。结论本研究显示,肢端肥大症患者妊娠结局良好,妊娠参数和并发症发生率均不高于非肢端肥大症患者。活动性肢端肥大症似乎对预后没有不利影响。
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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
期刊最新文献
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