Pregnancy outcomes in women with growth hormone deficiency

Capsule:
We describe pregnancies in a large group of patients with hypopituitarism, finding that GH replacement is not related to healthy live births, gestational age at delivery, and birth weight.

Authors:
Greisa Vila, M.D., Ann-Charlotte Akerblad, Ph.D., Anders F. Mattsson, Ph.D., Michaela Riedl, M.D., Susan M. Webb, Ph.D., Václav Hána, M.D., Eigil H. Nielsen, Ph.D., Beverly M.K. Biller, M.D., Anton Luger, M.D.

Volume 104, Issue 5, Pages 1210-1217

Abstract:

Objective:
To study pregnancies in a large group of patients with growth hormone deficiency and hypopituitarism; and to investigate potential factors determining pregnancy outcomes and pregnancy complications.

Design:
We analyzed pregnancies reported in KIMS, the Pfizer International Metabolic Database, of adult patients with growth hormone deficiency treated with growth hormone.

Setting:
Eighty-five outpatient clinics at medical centers in 15 countries.

Patient(s):
A total of 201 pregnancies were reported: 173 in female patients and 28 in partners of male patients.

Intervention(s):
Growth hormone replacement therapy (GHRT) was prescribed according to the local clinical practice.

Main Outcome Measure(s):
Pregnancy outcomes (live births, gestational week at delivery, and birth weight), pregnancy complications, and their relationship to use of GHRT during pregnancy were analyzed with regression models.

Result(s):
Two-thirds of women underwent fertility treatment to achieve pregnancy. Growth hormone replacement therapy was stopped before pregnancy in 7.5% of the female patients, as soon as pregnancy was confirmed in 40.1%, and at the end of the second trimester in 24.7% of the patients, whereas 27.6% continued GHRT throughout pregnancy. Birth of a healthy child was reported in 79% of the female pregnancies, nonelective abortions occurred mainly in the first trimester, and one fetal malformation (cystic hygroma) was diagnosed in the second trimester. Pregnancy outcomes and pregnancy complications were not related to GHRT treatment patterns, method of conception, or number of additional pituitary deficiencies.

Conclusion(s):
These data on pregnancy outcomes in a large group of women with hypopituitarism revealed no relationship between GHRT regimens and pregnancy outcomes.

  • Greisa Vila

    A detailed study of offspring would be very interesting, but is not planned. The database used for this study was closed in 2012 and therefore it is not possible to contact former investigators for obtaininig follow up information.

  • Shvetha Zarek

    This study provides reassuring evidence that patients with growth hormone deficiency are not at increased risk of adverse pregnancy outcomes compared to the general population. Do the authors plan on following the children in order to evaluate the prevalence of childhood onset growth hormone deficiency in the live births?

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