title: Results of a single-center observational 10-year survey study on recurrence of hyperprolactinemia after pregnancy and lactation.
abstract: BACKGROUND
  The current survey study investigated the recurrence rate of hyperprolactinemia after cabergoline (CAB)-induced pregnancy and after lactation as well as safety of CAB exposure during early gestation.
  
  
  METHODS
  From 1997-2008, 143 pregnancies were recorded in 91 patients with hyperprolactinemia (age 30.4 ± 4.7 yr, 76 microadenomas, 10 macroadenomas, and five nontumoral hyperprolactinemia). CAB therapy was discontinued within wk 6 of gestation in all. Pregnancies were monitored until delivery or termination, during and after lactation, twice yearly up to 60 months. The incidence of abortions, premature delivery, and fetal malformations was also analyzed.
  
  
  RESULTS
  Pregnancies resulted in 13 (9.1%) spontaneous abortions and 126 (88.1%) live births. No neonatal malformations and/or abnormalities were recorded. In 29 of 91 patients (three with macroadenomas), treatment with CAB had to be restarted within 6 months after lactation because of hyperprolactinemia recurrence, whereas in 68% of cases, no additional therapy was required up to 60 months. No tumor mass enlargement was observed. All patients but three were breastfeeding, 35 (38.5%) for less than 2 months and 56 (61.5%) for 2-6 months. Three months after cessation of lactation and 60 months after pregnancy, no difference in prolactin levels was found between patients nursing for less than 2 months and 2-6 months.
  
  
  CONCLUSIONS
  Fetal exposure to CAB at conception does not induce any increased risk of miscarriage or malformations. Pregnancy is associated with normalization of prolactin levels in 68% of patients. Breastfeeding does not increase the recurrence rate of hyperprolactinemia.
authors.affiliation: Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, via S. Pansini 5, I-80131 Napoli, Italy.
authors.forename: Renata S
authors.initials: RS
authors.lastname: Auriemma
authors.forename: Ylenia
authors.initials: Y
authors.lastname: Perone
authors.forename: Antonella
authors.initials: A
authors.lastname: Di Sarno
authors.forename: Ludovica F S
authors.initials: LF
authors.lastname: Grasso
authors.forename: Ermelinda
authors.initials: E
authors.lastname: Guerra
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gasperi
authors.forename: Rosario
authors.initials: R
authors.lastname: Pivonello
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001942:Breast Feeding; D000077465:Cabergoline; D003625:Data Collection; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use; D004873:Ergolines / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D007247:Infertility, Female / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D007774:Lactation / Q000097:blood / Q000502:physiology; D019370:Observation; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D015175:Prolactinoma / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology; D012008:Recurrence; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D018491:Dopamine Agonists; D004873:Ergolines; D000077465:Cabergoline