FRI300 Prolactinoma And Pregnancy: A Systematic Review And Meta-analysis

Abstract

Abstract Disclosure: D.B. Bandeira: None. L.S. Alves: None. A. Glezer: None. C.L. Boguszewski: None. V.S. Nunes-Nogueira: None. Introduction: Prolactinomas are the most common pituitary tumors, being an important cause of irregular menses and infertility. However, fertility can be restored, making pregnancy possible, especially for women who have achieved disease control, mainly on dopamine agonist (DA) treatment. Although literature data demonstrate safety in maternal and fetal outcomes, the evidence has not been systematically synthesized. Purpose: To perform a systematic review evaluating disease control and fetal and maternal outcomes in pregnancy of women with prolactinoma. Methods: We conducted a systematic review according to the Joanna Briggs Institute methodology for systematic reviews of etiology and risk. We included observational studies that evaluated pregnant women with prolactinoma. The outcomes of interest were spontaneous miscarriage, preterm birth, worsening of preexisting diabetes/development of gestational diabetes, tumor growth during pregnancy, headache, visual impairment, perinatal mortality, low birth weight, congenital malformations. Embase, Medline, LILACS, and CENTRAL were our source databases. To perform proportional meta-analyses, we used Stata Statistical Software 17. Results: Fifty-one studies were included encompassing a total of 2513 pregnancies in 1903 women with prolactinoma. The overall frequency of the pregnant women on DA at conception was 97% (from 49 studies of 2493 pregnancies; 95% confidence interval (CI), 93–99%); there were 9% of spontaneous miscarriage (from 38 studies of 2073 pregnancies; 95% CI, 7–12%), 3% of prematurity (from 38 studies of 1584 pregnancies; 95% CI, 3–2%), 9% of symptomatic tumor growth during pregnancy (from 38 studies of 1584 pregnancies; 95% CI, 5–15%), 4% of visual impairment (from 33 studies of 1480 pregnancies; 95% CI, 2–7%), 6% of headache (from 31 studies of 1385 pregnancies; 95% CI, 3–11%) and 4% of worsening of preexisting diabetes/development of gestational diabetes (from 9 studies of 666 pregnancies; 95% CI, 3–7%). The overall frequency of congenital malformations was 2% (from 23 studies of 1212 newborns; 95% CI, 1–4%), 2% of perinatal mortality (from 18 studies of 1123 newborns; 95% CI, 1–3%) and 6% of low birth weight (from 17 studies of 843 newborns; 95% CI, 3–9%). Conclusion: Pregnancy in women with prolactinoma is frequently safe in relation to fetal and maternal outcomes, presenting low frequency of spontaneous miscarriage, prematurity, tumor growth, visual impairment, headache, congenital malformations, perinatal mortality and of low birth weight. Presentation: Friday, June 16, 2023