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Clin Endocrinol (Oxf). 2018 Jun;88(6):896-907. doi: 10.1111/cen.13599. Epub 2018 Apr 18.

Outcome of pregnancies in a large cohort of women with acromegaly.

Author information

1
Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
2
Institute of Endocrinology, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
3
Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
4
Endocrinology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
5
Endocrine Service, AC Camargo Cancer Center, São Paulo, Brazil.

Abstract

OBJECTIVE:

To assess the outcome of pregnancies in a large cohort of women with acromegaly.

DESIGN AND METHODS:

This is a retrospective analysis of 31 pregnancies in 20 patients with acromegaly.

RESULTS:

Twenty-seven pregnancies resulted in healthy offspring, and 4 resulted in abortion. Three patients underwent transsphenoidal surgery during pregnancy. IGF-1 levels remained elevated during pregnancy in 4 pregnancies and normalized in 23 cases. Fifteen cases were followed during pregnancy without any medical or surgical treatment, and 13 of these exhibited normal IGF-1 levels. Before or during pregnancy, somatostatin receptor ligands usage was not associated with higher risk for adverse outcomes. Arterial hypertension worsening (45%) and impairment of glucose levels (32%) were the most common complications during pregnancies. There were no maternal or neonatal deaths. One woman delivered twins. Two cases of congenital malformations and one with foetal macrosomia were observed. Caesarean delivery was performed in sixteen cases.

CONCLUSION:

Our study confirms the impact of gestation on IGF-1 levels. However, it also indicates that acromegaly still holds an increased risk for worsening of comorbidities, especially in uncontrolled patients.

KEYWORDS:

IGF-1; acromegaly; complications; pregnancy

PMID:
29574986
DOI:
10.1111/cen.13599

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