Skip to main content
Log in

Effects of cabergoline on pregnancy and embryo-fetal development: retrospective study on 103 pregnancies and a review of the literature

  • Published:
Pituitary Aims and scope Submit manuscript

Abstract

The aim of the study is to assess the rate of any potential adverse effects on women who became pregnant under cabergoline (CAB) treatment and to evaluate any effects on the embryo-fetal development and on children who were born from mothers exposed to CAB in early weeks of gestation. Observational, retrospective and multicenter study on 103 pregnancies in 90 women with hyperprolactinemia. All patients were under CAB at conception. Serum prolactin at baseline was between 30 and 1921 ng/ml. Duration of therapy before pregnancy ranged from 1 to 120 months and doses ranged from 0.125 to 5 mg/week. Fetal exposure ranged from 3 to 25 weeks, 96.9% of patients received CAB during the first trimester of pregnancy and the rest until the second one. No significant complications during pregnancy were found. Seven women (7.2%) had spontaneous abortions. Preterm deliveries were recorded in eight (8.8%), only one with low weight for gestational age. Neonatal abnormalities were observed in 3 (3.6%): 1 major (Down syndrome) and 2 minor malformations (umbilical and inguinal hernia). We were able to asses the children’s development in 61. Two had epilepsy and two had Pervasive Developmental Disorder (PDD). No significantly higher frequency of complications was found in pregnancies and/or offspring exposed to CAB than in the normal population. We registered 2 abnormalities in the development of the children: epilepsy and PDD. Larger series of patients are needed to assess the safety of this drug during pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mah PM, Webster J (2002) Hyperprolactinemia: etiology, diagnosis and management. Semin Reprod Med 20(4):365–374

    Article  PubMed  Google Scholar 

  2. Molitch ME (1999) Medical treatment of prolactinomas. Endocrinol Metab Clin North Am 28(1):143–169

    Article  CAS  PubMed  Google Scholar 

  3. Turkalj I, Peter Braun P, Krupp P (1982) Surveillance of bromocriptine in pregnancy. JAMA 247(11):1589–1591

    Article  CAS  PubMed  Google Scholar 

  4. Molitch ME (1999) Management of prolactinomas during pregnancy. J Reprod Med 44(12):1121–1126

    CAS  PubMed  Google Scholar 

  5. Gillam MP, Molitch ME, Lombardi G, Colao A (2006) Advances in the treatment of prolactinomas. Endocr Rev 27:485–534

    Article  CAS  PubMed  Google Scholar 

  6. Ferrari C, Mattei A, Melis GB, Paracchi A, Muratori M, Faglia G, Sghedoni D, Crosignani PG (1989) Cabergoline: long-acting oral treatment of hiperprolactinemic disordes. J Clin Endocrinol Metab 68:1201–1206

    Article  CAS  PubMed  Google Scholar 

  7. Ciccarelli E, Giusti M, Miola C, Potenzoni F, Sghedoni D, Camanni F, Giordano G (1989) Effectiveness and tolerability of long term treatment with cabergoline, a new long-lasting ergoline derivative, in hyperprolactinemic patients. J Clin Endocrinol Metab 69:725–728

    Article  CAS  PubMed  Google Scholar 

  8. Ricci E, Parazzini F, Motta T, Ferrari C, Colao A, Clavenna A, Rocchi F, Gangi E, Paracchi S, Gasperi M, Lavezzari M, Nicolosi A, Simona Ferrero S, Landi M, Beck-Peccoz P, Bonati M (2002) Pregnancy outcome after cabergoline treatment in early weeks of gestation. Reprod Toxicol 16(6):791–793

    Article  CAS  PubMed  Google Scholar 

  9. Robert E, Musatti L, Piscitelli G, Ferrari C (1996) Pregnancy outcome after treatment with the ergot derivative, cabergoline. Reprod Toxicol 10:333–337

    Article  CAS  PubMed  Google Scholar 

  10. Colao A, Abs R, Gonzalez Bárcena D, Chanson P, Paulus W, Kleinberg D (2008) Pregnancy outcomes following cabergoline treatment: extended results from a 12- year observational study. Clin Endocrinol (Oxf) 68(1):66–71

    Article  CAS  Google Scholar 

  11. Ono M, Miki N, Amano K, Kawamata T, Seki T, Makino R, Takano K, Izumi SI, Okada Y, Hori T (2010) Individualized high-dose cabergoline therapy for hyperprolactinemic infertility in women with micro- and macroprolactinomas. J Clin Endocrinol Metab 95:2672–2679

    Article  CAS  PubMed  Google Scholar 

  12. Lebbe M, Hubinont C, Bernard P, Maiter D (2010) Outcome of 100 pregnancies initiated under treatment with cabergoline in hyperprolactinaemic women. Clin Endocrinol (Oxf) Apr 23 (Epub ahead of print) PMID:20455894

  13. Guillam P, Fideleff H, Boquete HR, Molitch ME (2004) Prolactin excess: treatment and toxicity. Ped Endocrinol Rev 2(Suppl1):108–114

    Google Scholar 

  14. Colao A, Loche S, Cappa M, Di Sarno A, Landi MA, Sarnacchiaro F, Facciolli G, Lombardi G (1998) Prolactinomas in children and adolescents. Clinical presentation and long-term follow-up. J Clin Endocrinol Metab 83:2777–2780

    Article  CAS  PubMed  Google Scholar 

  15. Stalldecker G, Mallea Gil MS, Guitelman M, Alfieri A, Ballarino MC, Boero L, Carabelli MA, Cornaló D, Chervin A, Danilowicz K, Fainstein Day P, García Basavilbaso N, Glerean M, Goyan V, Katz D, Loto MG, Manavela M, Nahmías JA, Rogozinski AS, Servidio M, Vitale NM (2010) Estudio Retrospectivo sobre las Posibles Complicaciones Materno-Fetales de la Exposición a Cabergolina. RAEM 47 (in press)

  16. www.eurocat.ulster.ac.uk

  17. Nazer Herrera J. Frecuencia de malformaciones en ECLAMC-Chile y en resto del ECLAMC www.redclinica.cl/html/archivos/30.pdf

  18. Zarante Montoya I, Castillo MC, García N, Suárez F, Gutiérrez CA, Umaña A (2002) Análisis clínico epidemiológico de factores asociados a malformaciones congénitas ECLAMC-Hospital Universitario San Ignacio junio- diciembre 2001 UNIVMED 43(2)

  19. Webster J, Piscitelli G, Polli A, Ferrari CI, Ismael I, Scanlon MF (1994) A comparison of cabergoline and bromocriptine in the treatment of hyperprolactinemic amenorrhea. Cabergoline Comparative Study Group. N Engl J Med 331:904–909

    Article  CAS  PubMed  Google Scholar 

  20. Cannavó S, Curtó L, Squadrito S, Almoto B, Vieni A, Trimarchi F (1999) Cabergoline: a first-choice treatment in patients with previously untreated prolactine–secreting pituitary adenoma. J Endocrinol Invest 22:354–359

    PubMed  Google Scholar 

  21. Verhelst J, Abs R, Maiter D, Van den Bruel A, Vandeweghe M, Velkeniers B, Movkel J, Lamberrigts G, Petrossians P, Coremans P, Mahler C, Stevenaert A, Verlooy J, Raftopoulos C, Beckers A (1999) Cabergoline in the treatment of hyperprolactinemia: a study in 455 patients. J Clin Endocrinol Metab 84:2518–2522

    Article  CAS  PubMed  Google Scholar 

  22. Ciccarelli E, Grottoli S, Razzore P, Gaia D, Bertagna A, Cirillo S, Cammarota T, Camanni M, Camanni F (1997) Long-term treatment with cabergoline, a new long-lasting ergoline derivate, in idiopathic or tumorous hyperprolactinaemia and outcome of drug-induced pregnancy. J Endocrinol Invest 20(9):547–551

    CAS  PubMed  Google Scholar 

  23. Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M (2000) Maternal age fetal loss: population based register linkage study. BMJ 320:1708–1712

    Article  CAS  PubMed  Google Scholar 

  24. Forsbach-Sánchez G, Tamez-Pérez HE, Hernández-Herrera R, Bafidis-Lechuga B (2009) Tratamiento del macroprolactinoma con cabergolina durante el embarazo. Rev Med Inst Mex Seguro Soc 47(3):307–310

    PubMed  Google Scholar 

  25. Jones J, Bashir T, Olney J, Wheatley T (1997) Cabergoline treatment for a large macroprolactinoma throughout pregnancy. J Obst Gynaecol Vol. 17(4):375–376

    Article  CAS  Google Scholar 

  26. Liu C, Tyrrell B (2001) Successful treatment of a large macroprolactinoma with cabergoline during pregnancy. Pituitary 4:179–185

    Article  CAS  PubMed  Google Scholar 

  27. Laloi-Michelin M, Ciraru-Vigneron N, Meas T (2007) Cabergoline treatment of pregnant women with macroprolactinomas. Int J Gynaecol Obstet 99(1):61–62

    Article  CAS  PubMed  Google Scholar 

  28. Sharma JB, Roy KK, Mohanraj P, Kumar S, Karmakar D, Barua J (2009) Pregnancy outcome in pituitary tumors. Arch Gynecol Obstet 280:401–404

    Article  PubMed  Google Scholar 

  29. Banerjee A, Wynne K, Tan T, Hatfield EC, Martin M, Williamson C, Meeran K (2009) High dose cabergoline therapy for a resistant macroprolactinoma during pregnancy. Clin Endocrinol(Oxf) 70(5):812–813

    Article  CAS  Google Scholar 

  30. Jones TH, Fraser RB (1994) Cabergoline treated hyperprolactinaemia results in pregnancy in a bromocriptine intolerant patient after seventeen years of infertility. Br J Obstet Gynaecol 101:349–350

    CAS  PubMed  Google Scholar 

  31. Bronstein MD, Salgado LR, Musolino NR (2002) Medical management of pituitary adenomas: the special case of the pregnant woman. Pituitary 5:99–107

    Article  CAS  PubMed  Google Scholar 

  32. La prematurez como problema de salud pública. www.sap.org.ar/docs/institucional/16.pdf

  33. Ata B, Seyhan A, Orhane S, Urman B (2009) High dose cabergoline in management of ovarian hyperstimulation syndrome. Fertil Steril 92(3):1168 e1–1168 e4

    Google Scholar 

  34. Alvarez C, Alonso-Muriel I, Garcia G, Crespo J, Bellver J, Simon C, Pellicer A (2007) Implantation is apparently unaffected by the dopamine agonist Cabergoline when administered to prevent ovarian hyperstimulation syndrome in women undergoing assisted reproduction treatment: a pilot study. Human Reprod 22(12):3210–3214

    Article  CAS  Google Scholar 

  35. Carizza C, Abdelmassih V, Abdelmassih S, Ravizzini P, Salgueiro L, Tudech Salgueiro P, Jine LT, Nagy P, Abdelmassih R (2008) Cabergoline reduces the early onset of ovarian hyperstimulation syndrome: a prospective randomized study. Reprod Biomed Online 17(6):751–755

    Article  CAS  PubMed  Google Scholar 

  36. Melcon M, Kochen S, Vergara R (2007) Prevalence and clinical features of epilepsy in Argentina. Neuroepidemiology 28(1):8–15

    Article  PubMed  Google Scholar 

  37. Somoza M, Forlenza R, Brussino M, Licciardi L (2005) Epidemiological survey of epilepsy in the primary school population in Buenos Aires. Neuroepidemiology 25(2):62–68

    Article  PubMed  Google Scholar 

  38. Van Naarden Braun K, Pettygrove S, Daniels J, Miller L, Nicholas J, Baio J, Schieve L, Kirby RS, Washington A, Brocksen S, Rahbar H, Rice C (2007) Centers for Disease Control and Prevention. Evaluation of a methodology for a collaborative multiple source surveillance network for autism spectrum disorders-Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2002. MMWR Surveillance Summaries 56(1):29–40

Download references

Acknowledgments

We would like to thank Dr José Luis Alonso for his encouragement and help in the obstetric area. We are grateful to Ms Claudia Muschitiello for her assistance in the English version. We deeply thank Dr Marina Mauro for her assistance in the manuscript. The following hospitals of Buenos Aires City participated in this study: Pirovano, Militar Central, Durand, Posadas, Clínicas José de San Martín, Rivadavia, Santa Lucía, Italiano, FLENI, Británico, Ramos Mejia, Alvarez.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Graciela Stalldecker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stalldecker, G., Mallea-Gil, M.S., Guitelman, M. et al. Effects of cabergoline on pregnancy and embryo-fetal development: retrospective study on 103 pregnancies and a review of the literature. Pituitary 13, 345–350 (2010). https://doi.org/10.1007/s11102-010-0243-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11102-010-0243-6

Keywords

Navigation