Pregnancy and perinatal outcome among hypothyroid mothers : a population-based cohort study
Turunen, Suvi; Vääräsmäki, Marja; Männistö, Tuija; Hartikainen, Anna-Liisa; Lahesmaa-Korpinen, Anna-Maria; Gissler, Mika; Suvanto, Eila (2019-01-23)
Suvi Turunen, Marja Vääräsmäki, Tuija Männistö, Anna-Liisa Hartikainen, Anna-Maria Lahesmaa-Korpinen, Mika Gissler, and Eila Suvanto. Thyroid. Jan 2019.135-141.http://doi.org/10.1089/thy.2018.0311
© 2019 Mary Ann Liebert, Inc., publishers. All rights reserved, USA and worldwide. Final publication is available from Mary Ann Liebert, Inc., publishers https://doi.org/10.1089/thy.2018.0311.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2021102952992
Tiivistelmä
Abstract
Background:Maternal hypothyroidism has been associated with adverse pregnancy outcomes. A large nationwide register-based cohort with data on medication purchases was established to study the associations between maternal hypothyroidism, levothyroxine (LT4) use, and pregnancy and perinatal complications.
Methods:The data included all singleton births between 2004 and 2013 (N = 571,785) in Finland. Hypothyroid mothers (n = 16,364) were identified in the Finnish Medical Birth Register. Of these women, 95.8% used LT4 medication, and 37.5% had consistent LT4 use during pregnancy. Hypothyroid mothers were compared to mothers without thyroid disease (N = 550,860) using logistic regression. The main outcome measures were pregnancy and perinatal complications.
Results:Maternal hypothyroidism was associated with several pregnancy and perinatal complications, including gestational diabetes mellitus (odds ratio [OR] = 1.19 [confidence interval (CI) 1.13–1.25]), gestational hypertension (OR = 1.20 [CI 1.10–1.30]), severe preeclampsia (OR = 1.38 [CI 1.15–1.65]), cesarean section (OR = 1.22 [CI 1.17–1.27]), preterm births (OR = 1.25 [CI 1.16–1.34]), large-for-gestational age newborns (OR = 1.30 [CI 1.19–1.42]), major congenital anomalies (OR = 1.14 [CI 1.06–1.22]), and neonatal intensive care unit admission (OR = 1.23 [CI 1.17–1.29]). However, among mothers with consistent LT4 purchases, only the associations between gestational diabetes mellitus (OR = 1.12 [CI 1.03–1.22]), cesarean section (OR = 1.13 [CI 1.06–1.21]), neonatal intensive care unit admission (OR = 1.09 [CI 1.01–1.29]), and large-for-gestational age newborns (OR = 1.26 [CI 1.10–1.45]) and maternal hypothyroidism remained.
Conclusions:Maternal hypothyroidism is associated with several pregnancy and perinatal complications, but consistent LT4 use may reduce many of the risks.
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