Endocrine Abstracts

Background

Data on female fertility, pregnancy, and outcome of offspring after childhood-onset craniopharyngioma (CP) are rare.

Study design

Observational study on pregnancy rate and outcome of offspring after CP in postpubertal, female patients recruited in KRANIOPHARYNGEOM 2000/2007 since 2000.

Results

451 CP patients (223 female) have been recruited. 269 CP patients (133 female) were postpubertal at study. Six of 133 female CP patients (4.5%) with a median age of 14.9 years at CP diagnosis had 9 pregnancies, giving birth to 10 newborns. Three patients achieved complete surgical resections. No patient underwent postoperative irradiation. Five natural pregnancies occurred in 3 CP patients without pituitary deficiencies. Four pregnancies were achieved in 3 CP with hypopituitarism under assisted reproductive techniques (ART) (after median 4.5 cycles, range: 3–6 cycles). Median maternal age at pregnancy was 30 years (range: 22–41 years). Six babies (60%) were delivered by caesarean section. Median gestational age at delivery was 38 weeks (range: 34–43 weeks); median birth weight was 2, 920 grams (range: 2, 270–3, 520 grams), the rate of preterm delivery was 33%. Enlargements of CP cysts occurred in 2 women during pregnancy. Other severe complications during pregnancy, delivery and postnatal period were not observed.

Conclusions

Pregnancies after CP are rare and achieved in 45% after ART. Close monitoring by an experienced reproductive physician is necessary. Due to a potentially increased risk for cystic enlargement, MRI of cystic CP is recommended during pregnancy. Severe perinatal complications, birth defects, and postnatal morbidity of mothers and offspring were not observed.