Obstetric outcomes in women with prolactinomas from a culturally diverse population: a matched cohort study

Abstract Purpose Prolactinomas are the most common type of pituitary adenomas in women of reproductive age. Data on obstetric outcomes in these women remain inconsistent, particularly in those exposed to dopamine agonists (DAs) during pregnancy. Most studies have been conducted in European and American populations, while data for other populations remain limited. We studied the prevalence of adverse obstetric outcomes in women with prolactinomas in the culturally diverse population of Australia. Methods This was a retrospective study of women with prolactinomas, treated at a metropolitan tertiary hospital and a co-located tertiary maternity centre in Melbourne, between 2021 and 2023. Controls were identified using a birth registry from the maternity hospital, matched for age, body mass index, parity, birth country and socio-economic status. Wilcoxon and Pearson's Chi-squared tests were used for statistical analyses. Results 65 pregnancies from 28 women were included, 29% of whom had macroprolactinomas. Most women were born in Oceania, Asia, and Africa. DAs were used at the time of conception in 51 pregnancies: 30 with cabergoline and 19 with bromocriptine. Medical therapies were continued in 9 women with macroprolactinomas, following shared medical decision-making. Symptomatic prolactinoma growth was observed in 2 pregnancies, neither required surgical management. The risks of adverse maternal (gestational diabetes mellitus, hypertension, and obstetric haemorrhage) and foetal outcomes (preterm delivery and congenital anomalies) in women with prolactinoma were comparable to those in the 260 control pregnancies. Conclusion Compared to matched controls, women with prolactinomas, with or without DA exposure, did not