标题：在中国188例患者中，溴隐亭停药时机对催乳素微腺瘤孕妇妊娠结局的影响：一项真实世界回顾性研究

 

目的：本研究旨在回顾性评估溴隐亭停药对垂体催乳素微腺瘤患者妊娠结局的影响，并分析其对母体健康和胎儿发育的双重影响。

 

方法：共诊断出188例垂体催乳素分泌型微腺瘤的孕妇 , who delivered at the Department of Obstetrics and gynecology.West China Second University Hospital of Sichuan University between January 2005 and June 2023, were included in this study. The patients were categorized into four groups based on their use and duration of bromocriptine therapy: Group A (46 patients) discontinued treatment at least one month prior to conception; Group B (49 patients) used bromocriptine until pregnancy was confirmed (≤8 weeks); Group C (53 patients) continued therapy until the end of the first trimester (8+1 to 12 weeks); and Group D (40 patients) continued bromocriptine use until the late stages of pregnancy (12+1 weeks until delivery). Maternal and neonatal outcomes were compared across these groups.

 

Results: Among the 188 patients, the incidence of neurological symptoms during pregnancy varied significantly across the groups (P=0.000), with the highest prevalence in Group A (21.7%) and minimal to no symptoms in Groups B, C, and D. The live birth rates and miscarriage rates did not show statistically significant differences across the groups (P=0.508). Premature birth rates were 6.5%, 6.2%, 13.2%, and 0% for Groups A, B, C, and D, respectively. Notably, the incidence of small-for-gestational-age (SGA) infants increased with prolonged bromocriptine use, while large-for-gestational-age (LGA) rates decreased, though these trends were not statistically significant (P=0.068). Median gestational age differed significantly across groups (P=0.000), but neonatal weights remained comparable (P=0.471).Gestational diabetes and pregnancy-induced hypertension did not differ significantly between groups (P=0.945 and P=0.878, respectively).

 

结论：在确认怀孕后停用溴隐亭通常对患有催乳素微腺瘤的患者是安全的。然而，对于那些有既存神经或眼科症状的患者，或在怀孕前未接受治疗的患者，怀孕期间肿瘤进展的风险较高，需要密切监测并可能继续使用多巴胺激动剂进行治疗。尽管长期使用溴隐亭可能导致出生体重降低，但需要进一步的前瞻性研究来阐明溴隐亭对胎儿发育的长期影响。

 

关键词：垂体催乳素微腺瘤，溴隐亭，妊娠结局，胎儿发育，多巴胺激动剂治疗