Gestational thyrotoxicosis, antithyroid drug use and neonatal outcomes within an integrated healthcare delivery system

Thyroid : Official Journal of the American Thyroid Association
Joan C LoMichael W Kuzniewicz

Abstract

Increasing attention has focused on the prevalence and outcomes of hyperthyroidism in pregnancy, given concerns for hepatotoxicity and embryopathy associated with antithyroid drugs (ATDs). In an integrated health care delivery system, we examined the prevalence of thyrotoxicosis and gestational ATD use (propylthiouracil [PTU] or methimazole [MMI]) in women with delivered pregnancies from 1996 to 2010. Birth outcomes were compared among all infants and those born to mothers with diagnosed thyrotoxicosis or ATD therapy during gestation, with examination of ATD-associated hepatotoxicity and congenital malformations in the latter subgroups. Among 453,586 mother-infant pairs (maternal age 29.7±6.0 years, 57.1% nonwhite), 3.77 per 1000 women had diagnosed thyrotoxicosis and 1.29 per 1000 had gestational ATD exposure (86.5% PTU, 5.1% MMI, 8.4% both). Maternal PTU-associated hepatotoxicity occurred with a frequency of 1.80 per 1000 pregnancies. Infants of mothers with diagnosed thyrotoxicosis (odds ratio [OR] 1.28, 95% confidence interval [CI 1.05-1.55]) or gestational ATD use (OR 1.31 [1.00-1.72]) had an increased risk of preterm birth compared to those born to mothers without thyrotoxicosis or ATD. The risk of neonatal intensive care...Continue Reading

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Citations

Nov 20, 2015·European Journal of Endocrinology·Stine Linding AndersenPeter Laurberg
Sep 12, 2015·Thyroid : Official Journal of the American Thyroid Association·Peter Laurberg, Stine Linding Andersen
Dec 15, 2015·Case Reports in Endocrinology·Alexander A LeungJulie McKeen
Aug 16, 2016·Thyroid : Official Journal of the American Thyroid Association·Douglas S RossMartin A Walter
Jun 10, 2016·European Journal of Endocrinology·Peter Laurberg, Stine Linding Andersen
Aug 7, 2017·European Journal of Endocrinology·Stine Linding AndersenOve Törring
Mar 7, 2018·Clinical Diabetes and Endocrinology·Caroline T NguyenJorge H Mestman
Aug 2, 2017·Birth Defects Research·Meredith M HowleyUNKNOWN National Birth Defects Prevention Study
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Aug 2, 2020·Birth Defects Research·Alfred N Romeo, Sarah G Običan
Aug 14, 2019·The Journal of Clinical Endocrinology and Metabolism·Stine Linding AndersenStig Andersen
Jul 2, 2020·Thyroid Research·Stine Linding Andersen, Stig Andersen
Jun 24, 2017·Current Opinion in Endocrinology, Diabetes, and Obesity·Stine L Andersen

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