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- Title
Pre-term birth in women exposed to Cushing's disease: the baby-cush study.
- Authors
Hochman, Clarisse; Cristante, Justine; Geslot, Aurore; Salenave, Sylvie; Sonnet, Emmanuel; Briet, Claire; Bachelot, Anne; Chevalier, Nicolas; Gilly, Olivier; Brue, Thierry; Hadjadj, Samy; Kerlan, Veronique; Chanson, Philippe; Vezzosi, Delphine; Chabre, Olivier; Drui, Delphine; Castinetti, Frederic
- Abstract
Design: Hypercortisolism during pregnancy is a risk factor for prematurity. Long-term exposure to hypercortisolism may lead to permanent comorbidities, such as hypertension or diabetes, even after remission. Our aim was to determine whether women with a history of Cushing's disease (and being eu-, hypo- or hypercortisolic at the time of pregnancy) had the same risks of comorbidities, and especially prematurity, during pregnancy. Methods: It was a retrospective multicentric study focusing on mothers with a history of Cushing's disease or diagnosed during pregnancy, followed in French tertiary referral centers. We compared the outcomes of pregnancies depending on the cortisolic status at the time of pregnancy. Results: A total of 60 patients (78 pregnancies including 21 with hyper cortisolism, 32 with hypocortisolism and 25 in eucortisolism in 25) were evaluated. The overall rate of preter m birth was 24.3%, with a peak in women diagnosed during pregnancy (62.5%), a high risk in hypercortisolic (33%) and hypocortisolic (19.3%), and a low risk (8%) in eucortisolic women Gestational diabetes and hypertension were o bserved in 21% and 10.4% of the whole cohort, with a higher risk in hypercortisolic women. Cesarean delivery was performed in 33.7% of the cohort. Conclusions: Being non-eucortisolic at the time of pregnancy increases the risk of prematurity and comorbidities compared to the general population. Women with a history of Cushing's disease should thus be carefully monitored during pregnancy. The high rate of cesarean delivery emphasizes the fact that these pregnancies should always be considered at risk.
- Subjects
CUSHING'S syndrome; CESAREAN section; PREGNANCY outcomes; GESTATIONAL diabetes; WOMEN'S history
- Publication
European Journal of Endocrinology, 2021, Vol 184, Issue 3, p473
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-20-1224