Introduction: Although the association between acromegaly and pregnancy has been studied, recent evidence synthesis is lacking. Objective: To evaluate the association between acromegaly and pregnancy in terms of disease control and newborn/maternal outcomes. Methods: We will perform a systematic review according to Joanna Briggs Institute methodology for systematic reviews of etiology and risk. We will include studies with pregnant women, over 18 years old, diagnosed with acromegaly before or during the first trimester of pregnancy. Studies with pregnancy before acromegaly diagnosis will be excluded. We will consider cohort and case-control studies, and case series (at least 3 participants). Maternal primary outcomes will be acromegaly control, preterm birth, presence of diabetes, hypertension and/or eclampsia, and frequency of abortion. Newborn primary outcomes will be perinatal mortality and low birthweight. General and adaptive search strategies have been created for the Embase, Medline, LILACS, and CENTRAL databases. Two independent reviewers will assess eligibility of the studies, extract data, and evaluate their risk of bias. For dichotomous data, effect estimates will be calculated using relative risk with 95% confidence intervals (CIs). Continuous data will be expressed as means and standard deviation (SD) for each study, and the mean difference will be calculated with respective 95% CIs. For non-controlled studies, maternal outcomes will be compared pre- and postpartum, and for abortion frequency and newborn outcomes, we will perform proportional meta-analysis. Conclusion: We hope that the results of this review can help the management of pregnant women with acromegaly.
Introduction: Prolactinomas are the most common pituitary tumors, especially affecting women in their 3rd and 4th decades, being an important cause of irregular menses and infertility. Fertility can be restored, making pregnancy possible, in most of the cases, mainly microprolactinomas, with clinical treatment (dopamine agonist (DA)) and eventually neurosurgery. Although literature data point to safety in maternal and fetal outcomes, especially regarding symptomatic tumor growth and DA fetal exposure, there is no meta-analysis. Ideal length of DA treatment in macroprolactinomas, abortion rate and neuropsychological development are important gaps in the management of DA- induced pregnancies. Objective: This systematic review aims to evaluate the association between pregnancy and prolactinoma with respect to the control of prolactinoma and fetal/maternal outcomes. Methods: This review will be conducted according to the Joanna Briggs Institute methodology for systematic reviews of etiology and risk. We will focus on observational studies that included pregnant women with prolactinoma. The outcomes will be prolactinoma control, preterm birth, maternal adverse events related to the use of DA, worsening of preexisting diabetes or the development of gestational diabetes, spontaneous miscarriage, frequency of breastfeeding, perinatal mortality, low birth weight, small for gestational age, congenital malformations, tumor size, headache, visual impairment, apoplexy, neurosurgery, clinical/biochemical recurrence of prolactinomas/hyperprolactinemia after pregnancy. Embase, Medline, LILACS, and CENTRAL will be our source databases. Two reviewers independently will select the studies, extract data and critically appraise the eligible studies. We will use Stata Statistical Software 17 to plot similar outcomes in at least two studies in meta-analyses. For controlled studies, relative risks will be calculated with 95% confidence intervals (CIs) as an estimate of the exposure effect, and for continuous data we will calculate means and standard deviations, and the mean differences will be calculated with respective 95% CIs. For uncontrolled studies we will perform proportional meta-analyses. The protocol of this review was registered in the PROSPERO database (registration number: CRD42021283757). Conclusions: The results of this review can help in the management of prolactinoma in women before, during and after pregnancy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.