Acromegaly and Pregnancy: a Systematic Review and Meta-Analysis

Introduction: Although the association between acromegaly and pregnancy has been studied, recent evidence synthesis is lacking. Objective: To evaluate the association between acromegaly and pregnancy in terms of disease control and newborn/maternal outcomes. Methods: We will perform a systematic review according to Joanna Briggs Institute methodology for systematic reviews of etiology and risk. We will include studies with pregnant women, over 18 years old, diagnosed with acromegaly before or during the first trimester of pregnancy. Studies with pregnancy before acromegaly diagnosis will be excluded. We will consider cohort and case-control studies, and case series (at least 3 participants). Maternal primary outcomes will be acromegaly control, preterm birth, presence of diabetes, hypertension and/or eclampsia, and frequency of abortion. Newborn primary outcomes will be perinatal mortality and low birthweight. General and adaptive search strategies have been created for the Embase, Medline, LILACS, and CENTRAL databases. Two independent reviewers will assess eligibility of the studies, extract data, and evaluate their risk of bias. For dichotomous data, effect estimates will be calculated using relative risk with 95% confidence intervals (CIs). Continuous data will be expressed as means and standard deviation (SD) for each study, and the mean difference will be calculated with respective 95% CIs. For non-controlled studies, maternal outcomes will be compared pre- and postpartum, and for abortion frequency and newborn outcomes, we will perform proportional meta-analysis. Conclusion: We hope that the results of this review can help the management of pregnant women with acromegaly.