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Cited by 50Growth Hormone and Insulin-like Growth FactorsPituitary Gland Disorders and TreatmentsHypothalamic control of reproductive hormones

Pregnancy outcomes in women with growth hormone deficiency

Open access
Vila, Greisa, Akerblad, Ann-Charlotte, Mattsson, Anders F., Riedl, Michaela, Webb, Susan M., Hána, Václav, Nielsen, Eigil H., Biller, Beverly M.K. +1 more·2015·Fertility and Sterility
DOI 10.1016/j.fertnstert.2015.07.1132
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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 Outpatient clinics.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.

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  • Differences in anterior and posterior pituitary blood supply may explain the relative sparing of ADH secretion.

    “Differences in anterior and posterior pituitary blood supply may explain the relative sparing of ADH secretion (258).”

    From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [258]

    Background Characteristics (page unavailable) reports ADH deficiency in 28% of these women, less often than the other listed pituitary deficiencies. The paper does not discuss differences in anterior and posterior pituitary blood supply or propose them as an explanation for relative sparing of ADH secretion. (LLM, conf=0.83)

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  • Partial or complete hypopituitarism is a prominent feature of pituitary apoplexy and contributes to high mortality.

    “Partial or complete hypopituitarism is a prominent feature and contributes to high mortality (257,258).”

    From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [258]

    The Background Characteristics section describes pituitary hormone deficiencies in pregnant patients with growth hormone deficiency, but does not identify pituitary apoplexy as their cause. A search of our copy for pituitary apoplexy and mortality found no passage addressing whether hypopituitarism is a prominent feature of apoplexy or contributes to mortality. (LLM, conf=0.76)

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  • More than 50% of patients eventually require hormonal replacement after pituitary apoplexy.

    “More than 50% of patients eventually require hormonal replacement (257,258,261).”

    From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [258]

    The Background Characteristics and Discussion describe hormone deficiencies and replacement in pregnant patients with growth hormone deficiency, not in patients after pituitary apoplexy. Searches for pituitary apoplexy and long-term hormone replacement found no passage reporting that more than 50% of apoplexy patients eventually require replacement. (LLM, conf=0.76)

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Research works printed but not linked: 2

  1. [1]1. Rosen T, Bengtsson BA. Premature cardiovascular mortality in hypopituita- rism. Lancet 1990;336:285-8.
  2. [19]19. Chandrashekar V, Zaczek D, Bartke A. The consequences of altered somato- tropic system on reproduction. Biol Reprod 2004;71:17-27.

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Authors
Vila, G., Akerblad, A.-C., Mattsson, A. F., Riedl, M., Webb, S. M., Hána, V., Nielsen, E. H., Biller, B. M. K., & Luger, A.
Affiliations
  • Medical University of Vienna (AT)
  • Pfizer (Sweden) (SE)
  • Universitat Autònoma de Barcelona (ES)
  • Charles University (CZ)
  • Aalborg University Hospital (DK)
  • Massachusetts General Hospital (US)
Corresponding author
Vila, Greisa
ORCID
Venue
Fertility and Sterility
Publisher
Elsevier BV
Published
2015-11
Volume
104
Issue
5
Pages
1210-1217.e1
ISSN
0015-0282 (ISSN-L)
DOI
10.1016/j.fertnstert.2015.07.1132
OpenAlex
W2158504647
Cited by
50
References
22
Citations by year
2026: 2 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 9 · 2021: 7 · 2020: 1 · 2019: 8 · 2018: 2 · 2017: 5 · 2016: 2
FWCI
2.60
Type
journal article
Language
en
Open access
Licence
Locations
  • Fertility and Sterility (publishedVersion)
  • PubMed (publishedVersion)
  • VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
Funders
Pfizer
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
Keywords
growth hormone deficiency, hypopituitarism, pregnancy outcomes, live birth rate, pregnancy complications, fetal malformations, cystic lymphangioma, infertility treatment, pituitary hormone deficiency, birth weight, gestational age at delivery
MeSH terms
Adolescent, Adult, Birth Weight, Drug Administration Schedule, Europe, Female, Gestational Age, Humans, Hypopituitarism, Male, Middle Aged, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prospective Studies, Risk Factors, Time Factors, United States, Biomarkers, Databases, Factual, Human Growth Hormone, Hormone Replacement Therapy, Reproductive Techniques, Assisted, Live Birth, Young Adult

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