Pregnancy outcomes following cabergoline treatment in hyperprolactinemic patients: an observational survey study
R. Auriemma, L. Grasso, A. Di Sarno, Y. Perone, R. Pivonello & A. Colao
Cabergoline (CAB) and other dopamine agonists are usually discontinued shortly after hyperprolactinemic patients become pregnant. Data on maternal and foetal exposure to CAB and on recurrence of hyperprolactinemia after pregnancy are still limited. The current survey study aimed at elucidating the safety of exposure to CAB during early pregnancy and the recurrence rate of hyperprolactinemia after pregnancy. Thus, 68 pregnancies in a cohort of 59 patients with hyperprolactinemia (age 37.2±5.5 years), including 51 patients with prolactin-secreting microadenomas, six with macroadenomas and two with non tumoral hyperprolactinemia, were evaluated. In all patients CAB therapy was recommended to be discontinued when pregnancy was confirmed. Pregnancies were monitored until delivery or termination according to routine clinical practice. Outcomes examined include the incidence of abortions, premature delivery and foetal malformations or abnormalities, as well as the recurrence rate of hyperprolactinemia after pregnancy. Pregnancies resulted in 10 (15%) spontaneous abortions and 58 (85%) live births. No neonatal malformations and/or abnormalities were recorded in our cohort. Only in five out of 59 patients treatment with CAB had to be restarted after pregnancy because of recurrence of hyperprolactinemia, whereas in 91.5% of cases no further therapy was required and patients were classified as in complete clinical and biochemical remission at last follow-up (48 months). In conclusion, foetal exposure to CAB at the time of conception and/or during pregnancy does not induce any increase in the risk of miscarriage or malformation. CAB withdrawal does not increase the risk of recurrence of hyperprolactinemia after pregnancy and pregnancy itself seems to increase the remission rate in CAB-treated hyperprolactinemia.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.