There is very little data available on pregnancy in people with Parkinson’s disease. Women with early-onset Parkinson’s who are of childbearing age do appear to have some risk of their Parkinson’s symptoms worsening during pregnancy, but they require no special care or precautions, and there do not appear to be any particular risks for the fetus. The safety of anti-parkinson’s medications in pregnancy is largely unknown: there are case reports (totaling 15 pregnancies in 12 patients) of uniformly no adverse effects on the unborn baby of sinemet, but there have been no reports of pregnancy’s on the nonergot-derived agonists. Amantadine might be associated with first-trimester obstetric complications including spontaneous abortion. A woman who is pregnant or attempting to become pregnant should not take ergot-derived medications such as the dopamine agonists bromocriptine (Parlodel) and pergolide (Permax), as these drugs influence the body’s production of prolactin, a hormone related to fertility and lactation, though the only report of a pregnancy on bromocriptine in the literature had no maternal or fetal complications. It is recommended that women who have Parkinson’s disease forgo breastfeeding, partly because some anti-Parkinson’s medications are expressed in breast milk and partly because the added fatigue factor tends to exacerbate Parkinson’s symptoms. Nonergot dopamine agonists have less effect on prolactin but still influence its production and thereby can cause reduced milk production.
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