Acromegaly and pregnancy: a systematic review

• Grant number: 20/04818-1
• Support type: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): June 01, 2020
• Effective date (End): May 31, 2021
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal researcher: Vania dos Santos Nunes Nogueira
• Grantee: Thainá Oliveira Felicio Olivatti
• Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Acromegaly is a chronic disease caused by the overproduction of growth hormone (GH) and consequently the growth factor similar to insulin type 1 (IGF1). Although some studies have published new and relevant information on the association of acromegaly with pregnancy, all the variables involved have not yet been studied, especially those related to safety for mothers and newborns. Objective: The objective of this review is to evaluate the association between pregnancy and acromegaly in relation to disease control and maternal and fetal outcomes. Methods: A systematic literature review will be carried out according to the methodology of the Joanna Brigs Institute (JBI), and we will include observational studies in which women with acromegaly became pregnant during the treatment / follow-up of this neoplasm. Primary maternal outcomes will be biochemical control of acromegaly, frequency of diabetes mellitus, hypertension and / or eclampsia. The outcomes of the newborns will be perinatal mortality and low birth weight. We will perform search strategies adapted to the following electronic databases: Embase (Elsevier, 1980-2020), Medline (PubMed, 1966-2020), LILACS (Virtual Health Library, 1982-2020) and the Cochrane Central Register of Controlled Trials (CENTRAL - Cochrane). The election process, the evaluation of the risk of bias and extracting data will be carried out in pairs and independently by two reviewers. The biochemical control of acromegaly will be compared before and after delivery, whose effect size will be based on the relative risk, or mean difference, and the meta-analysis will be performed using the JBI SUMARI (System for the Unified Management, Assessment and Review software) of Information). For the outcomes frequency of complications in pregnancy, perinatal mortality and low birth weight, the meta-analysis will be evaluated by the STATA software, version 12, metaprop command. The quality of the evidence will be generated according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. (AU)