First-generation somatostatin receptor ligands and pregnancy: lesson from women with acromegaly
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ORIGINAL ARTICLE
First-generation somatostatin receptor ligands and pregnancy: lesson from women with acromegaly Magaly Vialon1 Solange Grunenwald1 Céline Mouly1 Delphine Vezzosi1 Antoine Bennet1 Philippe Caron ●
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Received: 21 April 2020 / Accepted: 18 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Few data are available on the risks of first-generation somatostatin receptor ligands (SRLs) during pregnancy in women treated for acromegaly. Current recommendations suggest the withdrawal of treatment at diagnosis of pregnancy. The aims of this literature review were to evaluate the teratogenic effects and the potential impact of SRLs on maternal and fetal outcomes by comparing acromegalic patients treated or not during pregnancy. Patients and methods This study concerns 141 pregnancies in 127 women with acromegaly: 67 pregnancies in 62 women treated with SRLs during pregnancy and 74 pregnancies in 65 women not medically treated during pregnancy. A second analysis was then realized comparing women treated during 1st trimester only (36 pregnancies) and women treated longer (20 pregnancies). Results One malformation (ureteral stenosis) was reported in a newborn of a woman treated with SRL during pregnancy. No difference was found concerning maternal outcomes (gestational diabetes, hypertension, headaches, and delivery mode) and fetal outcomes (birth term, height, and weight). These results were also confirmed for the second analysis. Conclusions This review of the literature did report one malformation without being able to prove a specific link with the first-generation SRL treatment. No significant impact on maternal and fetal outcomes is related to first-generation SRL treatment in women with acromegaly. The number of pregnancies is still low and more data are necessary to conclude on the total safety of this treatment during gestation. In the meantime, based on the nonthreatening data from this review of literature, SRL treatment can be continued and/or reintroduced during pregnancy if necessary (mainly for persistent headaches) in women with acromegaly. Keywords Somatostatin receptors ligands Pregnancy Acromegaly Maternal outcomes Fetal malformation Gestational diabetes ●
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Introduction Acromegaly is a rare disease characterized by growth hormone (GH) and insulin growth factor‐1 (IGF‐1) hypersecretion, secondary to a pituitary adenoma. In women of reproductive age, acromegaly is often associated with infertility resulting from central hypogonadism, hyperprolactinemia, and polycystic ovary (PCO)‐like disease. As control of GH/IGF-1 hypersecretion can be obtained with
* Philippe Caron [email protected] 1
Department of Endocrinology and Metabolic Diseases, CHU Larrey, 24 chemin de Pouvourville, TSA 30030, 31059 Toulouse Cedex, France
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treatment, fertility is restored, pregnancy becomes possible with favorable issues for an increasing number of acromegalic women of reproductive age. Treatment of GH-secre
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