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Acta Obstet Gynecol Scand. 2008;87(6):617-27. doi: 10.1080/00016340802075103.

Maternal use of thyroid hormones in pregnancy and neonatal outcome.

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1
Department of Medicine, Karolinska Institutet, Clinical Pharmacology Unit, Karolinska University Hospital, Stockholm, Solna, Sweden. birgitta.norstedt-wikner@karolinska.se

Abstract

OBJECTIVE:

To describe neonatal outcome including the presence of congenital malformations in infants born to women substituted with thyroid hormones, and the maternal characteristics of these women.

DESIGN:

Register study based on prospectively collected data in relation to delivery.

SETTING:

Swedish Health Registers.

POPULATION:

All pregnant women (n=848,468) and all infants born (n=861,989) in Sweden from 1 July 1995 to 31 December 2004.

METHODS:

Women who reported the use of thyroid hormones in early pregnancy or obtained a prescription for thyroid hormones later in pregnancy (n=9,866), as well as their infants (n=10,055) were identified from the Swedish Medical Birth Register. The reference population consisted of all women giving birth and their offspring during the same time interval.

MAIN OUTCOME MEASURES:

Neonatal outcome, malformations and maternal characteristics. Data were analyzed with adjustments for identified confounders.

RESULTS:

Women using thyroxine had an increased rate of pre-eclampsia, diabetes (pre-existing or gestational), cesarean sections and inductions of labour compared to women in the reference population. The risk for preterm birth was marginally increased (OR 1.13, 95% CI 1.03-1.25). Neonatal thyroid disease was found in eight infants (seven with thyreotoxicosis and one unspecified), the expected number was 0.2. No further anomalies in neonatal diagnoses were found. A small but statistically significant risk for congenital malformations (OR =1.14, 95% CI 1.05-1.26) was found.

CONCLUSION:

Women on thyroid substitution during pregnancy had an increased risk for some pregnancy complications, but their infants were only slightly affected.

PMID:
18568461
DOI:
10.1080/00016340802075103
[Indexed for MEDLINE]
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