Risk of adverse perinatal outcomes with antithyroid treatment during pregnancy

A nationwide population-based study

C. H. Chen, S. Xirasagar, Chia-Chin Lin, L. H. Wang, Y. R. Kou, H. C. Lin

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objective To compare, using two large nationwide population-based data sets, the risk of adverse pregnancy outcomes (low birthweight [LBW], preterm birth, small for gestational age [SGA] and congenital anomalies) among pregnant women with hyperthyroidism classified into three groups: receiving propylthiouracil (PTU) treatment during pregnancy, receiving methimazole/carbimazole (MMI) treatment, and no antithyroid treatment during pregnancy. Design A matched case-control study. Setting Taiwan. Sample A total of 2830 mothers with hyperthyroidism and 14 150 age-matched randomly selected mothers without hyperthyroidism were included. Methods Conditional logistic regression analyses were performed to examine the risk of adverse pregnancy outcomes (LBW, preterm birth, SGA and major congenital anomalies) among these three groups. Main outcome measures LBW, preterm birth, SGA and major congenital anomalies. Results Women receiving PTU treatment during pregnancy had a higher risk of giving birth to LBW infants than those not receiving antithyroid treatment (odds ratio = 1.40; 95% CI 1.00-1.96), after adjusting for maternal education, anaemia, hyperlipidaemia, pregestational diabetes, pregestational hypertension, hyperemesis gravidarum and infant's gender and birth order. However, children of women receiving MMI treatment did not have increased risks of any adverse fetal outcome relative to mothers not receiving antithyroid treatment. Conclusions Our study finds an increased risk of LBW among babies of mothers with hyperthyroidism receiving PTU treatment during pregnancy relative to untreated mothers with hyperthyroidism.

Original languageEnglish
Pages (from-to)1365-1373
Number of pages9
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume118
Issue number11
DOIs
Publication statusPublished - Oct 2011

Fingerprint

Hyperthyroidism
Pregnancy
Mothers
Propylthiouracil
Population
Premature Birth
Carbimazole
Gestational Age
Methimazole
Therapeutics
Pregnancy Outcome
Hyperemesis Gravidarum
Birth Order
Hyperlipidemias
Taiwan
Case-Control Studies
Anemia
Pregnant Women
Logistic Models
Odds Ratio

Keywords

  • Antithyroid drugs
  • caesarean section
  • hyperthyroidism
  • perinatal outcome
  • propylthiouracil

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{625e72af8ba74e9daadd52bd1b55820b,
title = "Risk of adverse perinatal outcomes with antithyroid treatment during pregnancy: A nationwide population-based study",
abstract = "Objective To compare, using two large nationwide population-based data sets, the risk of adverse pregnancy outcomes (low birthweight [LBW], preterm birth, small for gestational age [SGA] and congenital anomalies) among pregnant women with hyperthyroidism classified into three groups: receiving propylthiouracil (PTU) treatment during pregnancy, receiving methimazole/carbimazole (MMI) treatment, and no antithyroid treatment during pregnancy. Design A matched case-control study. Setting Taiwan. Sample A total of 2830 mothers with hyperthyroidism and 14 150 age-matched randomly selected mothers without hyperthyroidism were included. Methods Conditional logistic regression analyses were performed to examine the risk of adverse pregnancy outcomes (LBW, preterm birth, SGA and major congenital anomalies) among these three groups. Main outcome measures LBW, preterm birth, SGA and major congenital anomalies. Results Women receiving PTU treatment during pregnancy had a higher risk of giving birth to LBW infants than those not receiving antithyroid treatment (odds ratio = 1.40; 95{\%} CI 1.00-1.96), after adjusting for maternal education, anaemia, hyperlipidaemia, pregestational diabetes, pregestational hypertension, hyperemesis gravidarum and infant's gender and birth order. However, children of women receiving MMI treatment did not have increased risks of any adverse fetal outcome relative to mothers not receiving antithyroid treatment. Conclusions Our study finds an increased risk of LBW among babies of mothers with hyperthyroidism receiving PTU treatment during pregnancy relative to untreated mothers with hyperthyroidism.",
keywords = "Antithyroid drugs, caesarean section, hyperthyroidism, perinatal outcome, propylthiouracil",
author = "Chen, {C. H.} and S. Xirasagar and Chia-Chin Lin and Wang, {L. H.} and Kou, {Y. R.} and Lin, {H. C.}",
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T1 - Risk of adverse perinatal outcomes with antithyroid treatment during pregnancy

T2 - A nationwide population-based study

AU - Chen, C. H.

AU - Xirasagar, S.

AU - Lin, Chia-Chin

AU - Wang, L. H.

AU - Kou, Y. R.

AU - Lin, H. C.

PY - 2011/10

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N2 - Objective To compare, using two large nationwide population-based data sets, the risk of adverse pregnancy outcomes (low birthweight [LBW], preterm birth, small for gestational age [SGA] and congenital anomalies) among pregnant women with hyperthyroidism classified into three groups: receiving propylthiouracil (PTU) treatment during pregnancy, receiving methimazole/carbimazole (MMI) treatment, and no antithyroid treatment during pregnancy. Design A matched case-control study. Setting Taiwan. Sample A total of 2830 mothers with hyperthyroidism and 14 150 age-matched randomly selected mothers without hyperthyroidism were included. Methods Conditional logistic regression analyses were performed to examine the risk of adverse pregnancy outcomes (LBW, preterm birth, SGA and major congenital anomalies) among these three groups. Main outcome measures LBW, preterm birth, SGA and major congenital anomalies. Results Women receiving PTU treatment during pregnancy had a higher risk of giving birth to LBW infants than those not receiving antithyroid treatment (odds ratio = 1.40; 95% CI 1.00-1.96), after adjusting for maternal education, anaemia, hyperlipidaemia, pregestational diabetes, pregestational hypertension, hyperemesis gravidarum and infant's gender and birth order. However, children of women receiving MMI treatment did not have increased risks of any adverse fetal outcome relative to mothers not receiving antithyroid treatment. Conclusions Our study finds an increased risk of LBW among babies of mothers with hyperthyroidism receiving PTU treatment during pregnancy relative to untreated mothers with hyperthyroidism.

AB - Objective To compare, using two large nationwide population-based data sets, the risk of adverse pregnancy outcomes (low birthweight [LBW], preterm birth, small for gestational age [SGA] and congenital anomalies) among pregnant women with hyperthyroidism classified into three groups: receiving propylthiouracil (PTU) treatment during pregnancy, receiving methimazole/carbimazole (MMI) treatment, and no antithyroid treatment during pregnancy. Design A matched case-control study. Setting Taiwan. Sample A total of 2830 mothers with hyperthyroidism and 14 150 age-matched randomly selected mothers without hyperthyroidism were included. Methods Conditional logistic regression analyses were performed to examine the risk of adverse pregnancy outcomes (LBW, preterm birth, SGA and major congenital anomalies) among these three groups. Main outcome measures LBW, preterm birth, SGA and major congenital anomalies. Results Women receiving PTU treatment during pregnancy had a higher risk of giving birth to LBW infants than those not receiving antithyroid treatment (odds ratio = 1.40; 95% CI 1.00-1.96), after adjusting for maternal education, anaemia, hyperlipidaemia, pregestational diabetes, pregestational hypertension, hyperemesis gravidarum and infant's gender and birth order. However, children of women receiving MMI treatment did not have increased risks of any adverse fetal outcome relative to mothers not receiving antithyroid treatment. Conclusions Our study finds an increased risk of LBW among babies of mothers with hyperthyroidism receiving PTU treatment during pregnancy relative to untreated mothers with hyperthyroidism.

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