Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2026
Prepregnancy Dopamine Agonist Treatment Duration as a Predictor of Postpartum Prolactinoma Remission.
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Park Seung Shin, Park Min-Jung, Kim Yong Hwy, Kim Jung Hee
Аннотация
OBJECTIVES: Prolactinoma is a major cause of infertility in women of reproductive age. Although pregnancy has been proposed to induce prolactinoma remission, evidence remains inconsistent because of the lack of well-matched control groups. This study evaluated the impact of pregnancy on prolactinoma outcomes and identified predictors of sustained postpartum remission.
METHODS: We retrospectively analyzed 225 women with prolactinoma treated between 2003 and 2024. Seventy-five patients who became pregnant during dopamine agonist (DA) therapy were matched 1:2 with 150 nonpregnant controls using propensity score matching based on age, baseline prolactin levels, and tumor size. Logistic regression and Kaplan-Meier analyses were performed to assess remission outcomes and identify independent predictors.
RESULTS: Baseline characteristics were well balanced between groups. At the last follow-up (median 110.0 months for the pregnancy group), the final remission rates were comparable between groups (20.0% vs 14.7%, P = .342). Pregnancy was not associated with prolactinoma remission in the overall cohort (P = .576). Among women who became pregnant, a prepregnancy DA treatment duration >48 months was the only significant independent predictor of remission (odds ratio 4.48, 95% confidence interval 1.31-15.36; P = .017). Kaplan-Meier analysis demonstrated significantly higher recurrence-free probability in patients treated for >48 months before conception (P = .020), whereas the 36-month threshold was not significant (P = .103).
CONCLUSION: Pregnancy itself did not influence the long-term prolactinoma remission. Instead, sustained postpartum remission was associated with at least 48 months of DA therapy before conception, highlighting the importance of adequate treatment duration prior to pregnancy.
METHODS: We retrospectively analyzed 225 women with prolactinoma treated between 2003 and 2024. Seventy-five patients who became pregnant during dopamine agonist (DA) therapy were matched 1:2 with 150 nonpregnant controls using propensity score matching based on age, baseline prolactin levels, and tumor size. Logistic regression and Kaplan-Meier analyses were performed to assess remission outcomes and identify independent predictors.
RESULTS: Baseline characteristics were well balanced between groups. At the last follow-up (median 110.0 months for the pregnancy group), the final remission rates were comparable between groups (20.0% vs 14.7%, P = .342). Pregnancy was not associated with prolactinoma remission in the overall cohort (P = .576). Among women who became pregnant, a prepregnancy DA treatment duration >48 months was the only significant independent predictor of remission (odds ratio 4.48, 95% confidence interval 1.31-15.36; P = .017). Kaplan-Meier analysis demonstrated significantly higher recurrence-free probability in patients treated for >48 months before conception (P = .020), whereas the 36-month threshold was not significant (P = .103).
CONCLUSION: Pregnancy itself did not influence the long-term prolactinoma remission. Instead, sustained postpartum remission was associated with at least 48 months of DA therapy before conception, highlighting the importance of adequate treatment duration prior to pregnancy.