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Area of Science:

  • Reproductive Endocrinology
  • Pharmacology
  • Obstetrics

Background:

  • Hyperprolactinemia, often caused by prolactinomas, is a significant factor in female infertility.
  • Dopamine agonists (DA) are the primary treatment for hyperprolactinemia.
  • Bromocriptine (BRC) is traditionally recommended for pregnancy due to its established safety record in over 6,000 pregnancies.

Purpose of the Study:

  • To critically evaluate the safety of cabergoline (CAB) during pregnancy.
  • To compare the safety profile of CAB with BRC in pregnant women with prolactinomas.

Main Methods:

  • Literature review and critical evaluation of existing studies on dopamine agonist use in pregnancy.
  • Analysis of data concerning pregnancy outcomes, including preterm delivery and fetal malformations, for both CAB and BRC.

Main Results:

  • While BRC has a larger safety dataset in pregnancy, approximately 800 pregnancies have been reported with CAB.
  • Data do not indicate an increased risk of preterm delivery or fetal malformations with CAB compared to BRC or the general population.
  • Limited case reports (around ten) of CAB use throughout pregnancy show no evidence of harm to fetal development.

Conclusions:

  • Bromocriptine (BRC) remains the recommended dopamine agonist for inducing or maintaining pregnancy in women with prolactinomas.
  • Emerging evidence suggests that cabergoline (CAB) is also safe for use during pregnancy.
  • Further research may solidify CAB's role as a safe alternative for pregnant women with hyperprolactinemia.