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First-generation somatostatin receptor ligands and pregnancy: lesson from women with acromegaly

Magaly Vialon1, Solange Grunenwald1, Céline Mouly1

  • 1Department of Endocrinology and Metabolic Diseases, CHU Larrey, 24 chemin de Pouvourville, TSA 30030, 31059, Toulouse Cedex, France.

Endocrine
|August 1, 2020
PubMed
Abstract

Insights

First-generation somatostatin receptor ligands (SRLs) show no significant impact on maternal or fetal outcomes in acromegaly pregnancies. While one malformation was noted, a direct link to SRL treatment is unproven, suggesting continued use may be safe.

Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Pharmacology

Background:

  • Limited data exist on first-generation somatostatin receptor ligands (SRLs) risks during pregnancy for acromegaly patients.
  • Current guidelines recommend discontinuing SRL treatment upon pregnancy diagnosis.

Purpose of the Study:

  • To evaluate teratogenic effects of first-generation SRLs in pregnancy.
  • To assess the impact of SRL treatment on maternal and fetal outcomes in acromegaly patients.

Main Methods:

  • Literature review of 141 pregnancies in 127 women with acromegaly.
  • Comparison of outcomes between pregnancies treated with SRLs and those untreated during gestation.
  • Sub-analysis comparing treatment during the first trimester only versus longer treatment durations.

Main Results:

  • One case of ureteral stenosis reported in a newborn exposed to SRLs; causality unproven.
  • No significant differences in maternal outcomes (gestational diabetes, hypertension, delivery mode) or fetal outcomes (term, height, weight) were observed.
  • Sub-analysis confirmed these findings.

Conclusions:

  • First-generation SRL treatment during pregnancy for acromegaly appears safe, with no proven teratogenic link or significant impact on maternal/fetal health.
  • While data are limited, SRLs can be continued or reintroduced during pregnancy if clinically necessary, particularly for persistent headaches.
  • Further research is needed to confirm the overall safety profile of SRLs throughout gestation.
Keywords:
AcromegalyFetal malformationGestational diabetesMaternal outcomesPregnancySomatostatin receptors ligands

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