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First-generation somatostatin receptor ligands and pregnancy: lesson from women with acromegaly

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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.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolic Diseases, CHU Larrey, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex, France

    Magaly Vialon, Solange Grunenwald, Céline Mouly, Delphine Vezzosi, Antoine Bennet & Philippe Caron

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  1. Magaly Vialon
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  2. Solange Grunenwald
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  3. Céline Mouly
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  6. Philippe Caron
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All authors contributed to the study conception and design. The first draft of the manuscript was written by M.V. and all authors commented on previous versions of the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Philippe Caron.

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Vialon, M., Grunenwald, S., Mouly, C. et al. First-generation somatostatin receptor ligands and pregnancy: lesson from women with acromegaly. Endocrine 70, 396–403 (2020). https://doi.org/10.1007/s12020-020-02430-1

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