An observational study of pregnancy and post-partum outcomes in women with prolactinoma treated with dopamine agonists

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dc.contributor.author O'Sullivan, SM en
dc.contributor.author Farrant, MT en
dc.contributor.author Ogilvie, CM en
dc.contributor.author Gunn, Alistair en
dc.contributor.author Milsom, Stella en
dc.date.accessioned 2019-11-25T00:25:15Z en
dc.date.issued 2019-10-03 en
dc.identifier.issn 0004-8666 en
dc.identifier.uri http://hdl.handle.net/2292/49107 en
dc.description.abstract BACKGROUND: In women with prolactinoma medical treatment with dopamine agonists (DA) can restore fertility. A number of studies have established the safety of DA during pregnancy and the impact of pregnancy and lactation on remission of prolactinoma. However, the total number of reported cases remains modest and further evidence is needed. AIMS: To evaluate the safety of DA during pregnancy and remission of prolactinoma after pregnancy and lactation. MATERIALS AND METHODS: Retrospective cohort study (2002-2014) of 57 pregnancies in 47 women with prolactinoma who received DA. Neonatal and pregnancy complications were recorded. Prolactin levels and treatment data were collected at the time of diagnosis, pre-conception, during pregnancy and lactation, and post-partum (up to 114 months). RESULTS: DA treatment was stopped a median of 4.5 weeks after conception in 49 pregnancies (86%). There were 49 live births (86% of pregnancies) and six miscarriages. Six pregnancies had an adverse neonatal outcome including two with congenital malformations. Following 26% of pregnancies women achieved remission after birth or lactation, and 25% of women were in remission at last follow-up. Remission was associated with older maternal age (P = 0.036), a lower prolactin level at diagnosis (P = 0.037), and a smaller adenoma at diagnosis (P = 0.045). CONCLUSIONS: Successful pregnancy and lactation is common after DA treatment for prolactinoma. Fetal exposure in the first four weeks of pregnancy appears to be generally safe. Encouragingly, post-partum and after lactation a quarter of women had a normal prolactin level without medical treatment. en
dc.language English en
dc.publisher WILEY en
dc.relation.ispartofseries AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Science & Technology en
dc.subject Life Sciences & Biomedicine en
dc.subject Obstetrics & Gynecology en
dc.subject bromocriptine en
dc.subject cabergoline en
dc.subject lactation en
dc.subject pregnancy en
dc.subject prolactinoma en
dc.subject CABERGOLINE TREATMENT en
dc.subject LUTEINIZING-HORMONE en
dc.subject TUMOR OUTCOMES en
dc.subject HYPERPROLACTINEMIA en
dc.subject LACTATION en
dc.subject SECRETION en
dc.title An observational study of pregnancy and post-partum outcomes in women with prolactinoma treated with dopamine agonists en
dc.type Journal Article en
dc.identifier.doi 10.1111/ajo.13070 en
dc.rights.holder Copyright: The author en
pubs.author-url http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000488745500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=6e41486220adb198d0efde5a3b153e7d en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 784213 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Medical Sciences en
pubs.org-id Physiology Division en
dc.identifier.eissn 1479-828X en
pubs.record-created-at-source-date 2019-10-26 en
pubs.dimensions-id 31583693 en


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