scholarly journals The Increased Trend of Medical Treatment for Thyroid Diseases during Pregnancy: A 13-Year National Study

2021 ◽  
pp. 1-7
Author(s):  
Suvi Turunen ◽  
Marja Vääräsmäki ◽  
Maarit Leinonen ◽  
Mika Gissler ◽  
Tuija Männistö ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Drug Prescription ◽  
Antithyroid Drug ◽  
Fold Increase ◽  
Study Data ◽  
National Study ◽  
Antithyroid Drugs ◽  
Thyroid Disorders ◽  
Medical Birth Register ◽  
Hormone Use

<b><i>Objective:</i></b> Thyroid dysfunction affects up to 5–7% of all pregnancies. The rates of thyroid hormone use in nonpregnant population have substantially increased in recent years. The aim of this study was to assess possible changes in the use of levothyroxine substitution and antithyroid drugs over time in pregnant women. <b><i>Methods:</i></b> The study data consisted of all singleton pregnancies (<i>N</i> = 736,873) between 2004 and 2016 in Finland collected from the Finnish Medical Birth Register. The Prescription Register and Special Refund Entitlement Register provided information on levothyroxine and antithyroid drug purchases. The annual rates of levothyroxine and antithyroid drug prescription redemptions were explored to estimate changes in exposure rates to thyroid medication from 2004 to 2016. Joinpoint regression analyses were performed to explore interannual variability in levothyroxine and antithyroid drug treatment. <b><i>Results:</i></b> There was more than a five-fold increase in levothyroxine use during the study period; in 2004, 1.1% of pregnant women had levothyroxine treatment, and by 2016, the prevalence increased to 6.2%. In addition, we observed a slight increase in antithyroid medication during pregnancy, but antithyroid drug use during pregnancy overall was very rare. In 2004, 0.05% of pregnant women used antithyroid drugs, and by 2016, this percentage had increased to 0.14%. <b><i>Conclusions:</i></b> Our study shows that the rate of levothyroxine use in pregnancy has markedly increased. This suggests that tracing and screening relevant patients and awareness of thyroid disorders on pregnancy and their significance for the pregnancy outcome have increased and the threshold to treat thyroid disorders has declined.

Treatment of maternal hyperthyroidism with antithyroid agents and changes in thyrotrophin and thyroxine in the newborn

1981 ◽  
Vol 97 (2) ◽  
pp. 186-195 ◽  
Author(s):  
B.-A. Lamberg ◽  
E. Ikonen ◽  
K. Teramo ◽  
G. Wägar ◽  
K. Österlund ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Cord Blood ◽  
Pregnant Women ◽  
Newborn Infants ◽  
Antithyroid Drug ◽  
Clinical Indication ◽  
Antithyroid Drugs ◽  
Serum Thyroxine ◽  
Antithyroid Agents ◽  
Serum Tsh

Abstract. Eleven pregnant women with concomitant hyperthyroidism were treated with antithyroid drugs. At monthly intervals serum thyroxine (T4) and triiodothyronine (T3) were measured with radioimmunoassay, the Sephadex uptake of radioactive triiodothyronine (T3U) determined and the free T4 and T3 indices calculated (FT4I, FT3I). TSH-binding inhibiting immunoglobulins (TBII) were determined by the radiomembrane assay. Serum TSH and T4 were measured at delivery from cord blood and/or from the newborn infants some days after birth. Serum TSH was significantly elevated in one infant. There was an inadequate post-partal rise in serum T4 concentration in this child and in another who showed only a marginal elevation of TSH. The mothers of these infants were given carbimazole in doses of 30 and 25 mg/day, respectively, at the time of delivery. No significant changes were seen in other infants, the daily doses being 20 mg of carbimazole or less. There was no clinical indication of hypo- or hyperthyroidism in any of the newborn. The TBII were positive in most patients and there was a trend of normalization during treatment. No relationship between the dose of antithyroid drug and the level of TBII could be seen. During treatment the dose was adjusted according to the FT3I values. This seems to be an adequate laboratory test for this purpose.

scholarly journals Thyroid disorders in subfertility and early pregnancy

2020 ◽  
Vol 11 ◽  
pp. 204201882094585
Author(s):  
Samantha Anandappa ◽  
Mamta Joshi ◽  
Lukasz Polanski ◽  
Paul V. Carroll
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Current Knowledge ◽  
Thyroid Autoimmunity ◽  
Thyroid Disorders ◽  
Thyroid Function Tests ◽  
Increased Risk ◽  
Hormone Use ◽  
Current Knowledge Base ◽  
In Pregnancy

Disorders of thyroid function are common in pregnancy and have implications for foetal and maternal health. Thyroid autoimmunity, as evidenced by the presence of elevated levels of anti-thyroid antibodies (anti-TPO and anti-Tg antibodies) is associated with an increased risk of miscarriage, though the mechanism remains poorly understood. There has been considerable focus on the implications and optimal management of pregnant women with thyroid disease, especially those undergoing assisted reproduction. Pregnancy results in significant changes in thyroid physiology and these need to be understood by clinicians involved in the care of pregnant women. Guidelines for the use of thyroxine and target thyroid function tests have been produced by international bodies but it is recognised that these predominantly reflect expert opinion rather than established evidence-based practice. Importantly a number of key clinical trials have been performed to aid understanding, particularly of the consequences of hypothyroidism for mother and baby, and the effectiveness of thyroid hormone use in autoimmune and subclinical hypothyroidism. This review summarises the current knowledge base and guidance for practice relating to thyroid disorders in pregnancy and subfertility.

scholarly journals Frequency of Adverse Events of Antithyroid Drugs Administered during Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Ai Yoshihara ◽  
Jaeduk Yoshimura Noh ◽  
Natsuko Watanabe ◽  
Kenji Iwaku ◽  
Sakiko Kobayashi ◽  
...  
Keyword(s):  
Adverse Events ◽  
Pregnant Women ◽  
Antithyroid Drug ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Newly Diagnosed ◽  
Cutaneous Reactions ◽  
First Time

The frequency and types of adverse events after initial antithyroid drug (ATD) therapy during pregnancy have never been reported, nor has whether the frequency of adverse events is the same as among nonpregnant subjects ever been investigated. We investigated retrospectively the frequency of adverse events after initial ATD administration to previously untreated Graves’ disease (GD) patients during pregnancy. We reviewed the charts of cases of 91 untreated pregnant women who came to our hospital for the first time and were newly diagnosed with GD during the period between January 1, 1999, and December 31, 2011. Thiamazole (MMI) was used to treat 40 patients and 51 patients were treated with propylthiouracil (PTU). Adverse events occurred in 5 patients (5/40; 12.5%) treated with MMI, and they consisted of cutaneous reactions in 5 patients. Adverse events occurred in five patients (5/51; 9.8%) treated with PTU, and they consisted of hepatotoxicity in two patients and cutaneous reactions in three patients. No patients experienced agranulocytosis or ANCA-related vasculitis. Comparison with the expected rate of adverse events in nonpregnant individuals showed that the frequency of adverse events in pregnant individuals was low.

Graves'-Basedow disease in pregnancy

2015 ◽  
Vol 54 (03) ◽  
pp. 106-111 ◽  
Author(s):  
S. L. Andersen ◽  
P. Laurberg
Keyword(s):  
Side Effects ◽  
Birth Defects ◽  
Thyroid Dysfunction ◽  
National Study ◽  
Antithyroid Drugs ◽  
Upper Limit ◽  
Special Concern ◽  
Maternal Thyroid ◽  
Toxic Reactions ◽  
Serum Tsh

SummaryThyroid hormones are essential development factors and maternal thyroid dysfunction may cause pregnancy complications and diseases in the fetus/child. In the present review we discuss new data on the incidence of Graves'-Basedow disease (GBD) in and around pregnancy, and how hyperthyroidism may affect the risk of spontaneous abortion and stillbirth.A special concern in pregnant women is the potential side effects from the use of antithyroid drugs (ATDs). One type of side effects is the allergic/toxic reactions to the drugs, which seem to be similar in and outside pregnancy, and another is that ATDs tend to over treat the fetus when the mother with GBD is made euthyroid. To avoid fetal hypothyroidism, the lowest possible ATD dose should be used to keep maternal thyroid function at the upper limit of normality with low serum TSH. Birth defects after the use of methimazole (MMI) (or its prodrug carbimazole) have been considered to be very rare, and no risk has previously been associated with the use of propylthiouracil (PTU). However, a recent Danish national study found that 1/30 of children exposed to MMI in early pregnancy had birth defects associated with this, and many defects were severe. PTU exposure was associated with defects in 1/40, and these defects were less severe. Proposals are given on how to reduce the risk of ATD associated birth defects.

Effects of high and low doses of methimazole in patients with Graves' thyrotoxicosis

1987 ◽  
Vol 116 (1_Suppl) ◽  
pp. S312-S317 ◽  
Author(s):  
G. Benker ◽  
D. Reinwein ◽  
H. Creutzig ◽  
H. Hirche ◽  
W. D. Alexander ◽  
...  
Keyword(s):  
Antithyroid Drug ◽  
Drug Dosage ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Duration Of Treatment ◽  
Disease Heterogeneity ◽  
Remission Rates ◽  
Set Up ◽  
The Many ◽  
The Impact

Abstract. In spite of the long-established use of antithyroid drugs, there are many unsettled questions connected with this treatment of Graves' disease. There is a lack of controlled prospective trials studying the results of antithyroid drug therapy while considering the many variables such as disease heterogeneity, regional differences, drug dosage and duration of treatment. Therefore, a multicenter study has been set up in order to compare the effects of two fixed doses of methimazole (10 vs 40 mg) with thyroid hormone supplementation on the clinical, biochemical and immunological course of Graves' disease and on remission rates. Experience accumulated so far suggests that treatment is safe using either 10 or 40 mg of methimazole. While there is a tendency for an advantage of the higher dose within the first weeks (higher effectiveness in controlling hyperthyroidism), this difference is not significant. The impact of dosage on remission rates remains to be shown.

scholarly journals Remission Rate of Graves' Disease and the Trend of Changes in Serum TSH Receptor Antibodies in Prolonged Antithyroid Drug Treatment

2020 ◽  
Vol 18 (Suppl) ◽  
Author(s):  
Danilo Villagelin ◽  
Roberto Bernardo Santos ◽  
João Hamilton Romaldini
Keyword(s):  
Drug Treatment ◽  
Remission Rate ◽  
Antithyroid Drug ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Remission Rates ◽  
Thyrotropin Receptor Antibodies ◽  
Antithyroid Drug Treatment ◽  
The Impact ◽  
Receptor Antibodies

Context: Graves’ disease is an autoimmune disease caused by thyrotropin receptor antibodies (TRAb). These antibodies can be measured and used for the diagnosis, prediction of remission, and risk of Graves’ orbitopathy development. There are three treatments for Graves’ disease that have remained unchanged for the last 75 years: Antithyroid drugs, radioiodine, and surgery. Antithyroid drugs are the first treatment option worldwide and are usually used for 12 - 18 months. Recent reports suggest the use of antithyroid drugs for more than 18 months with better outcomes. This review focuses on two aspects of treatment with antithyroid drugs: The impact of using antithyroid drugs for more than 12 - 18 months on remission rates and the trend of TRAb during prolonged antithyroid drug treatment. Evidence Acquisition: A review was performed in Medline on the published work regarding the duration of ATD treatment and remission of Graves' disease and also ATD treatment and TRAb status during the 1990 - 2019 period. Results: Remission rates are variable (30% - 80%), and many clinical and genetic factors serve as predictors. The long-term use of antithyroid drugs appears to increase remission rates. TRAb values usually decline during ATD treatment, but the trend could occur in two ways: Becoming negative or showing a fluctuating pattern. However, approximately 10% of the patients will remain TRAb-positive after five years of treatment with antithyroid drugs. Conclusions: Antithyroid drugs can be used for long periods with an increase in remission rates, and a gradual decrease in TRAb levels, with the disappearance of TRAb in 90% of the patients after 60 months.

scholarly journals The Effect of Socioeconomy on Chronic Energy Deficiency among Pregnant Women in the Sudiang Raya Health Center, 2019

2020 ◽  
Vol 8 (T2) ◽  
pp. 115-118
Author(s):  
Nofita Setiorini Futri Purwanto ◽  
Masni Masni ◽  
M. Nadjib Bustan
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Maternal Education ◽  
Study Data ◽  
Influential Factor ◽  
Control Groups ◽  
Chi Square ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency ◽  
Control Research

BACKGROUND: Chronic energy deficiency (CED) is a condition of malnutrition of pregnant women which have an advanced impact in the form of health problems and complications in the mother and baby. For this reason, it is necessary to work toward prevention by knowing the socioeconomic influence on CED. AIM: The aim of the study was to determine the effect of socioeconomics on the incidence of CED in pregnant women. METHODS: This research is observational analytic with case–control research design. A sample of 99 pregnant women was taken from the working area of the Sudiang Raya Health Center. This sample consisted of 33 case groups of mothers with CED and 66 control groups of pregnant women who did not suffer from CED who had met the inclusion and exclusion criteria of the study. Data were analyzed using analysis Chi-square and multiple logistic regression. RESULTS: The results showed that maternal occupation (p = 0.018; odds ratio [OR] = 6.091; confidence interval [CI] 95% 1.367–27.133) was significant for CED, whereas that education (p = 0.213; OR = 0.593; CI 95% 0.260–1.351) and income (p = 0.576; OR = 0.733; 95% CI 0.247–2.179) are not significant to CED. Based on multivariate analysis we found that the most influential factor was occupation (adjusted OR = 11.734, CI 95% 1.253–109.91). CONCLUSION: Based on the results of research and discussion, it can be concluded that work affects the CED in pregnant women, while maternal education and income have no effect on CED in pregnant women. Occupation is the most influential factor on the CED, women who do not work have a risk of 11.734 times experiencing CED compared to women who work.

scholarly journals Factors Influencing Pregnant Women's Participation in Prenatal Classes in Magetan Regency, Indonesia

2021 ◽  
Author(s):  
Rofiatul Uzza ◽  
Sapto Adi ◽  
Suci Puspita Ratih
Keyword(s):  
Pregnant Women ◽  
Infant Health ◽  
Health Workers ◽  
Binary Logistic Regression ◽  
Study Data ◽  
Health Promotion Program ◽  
P Value ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Women's Participation

Prenatal classes in Indonesia are government’s effort to improve the knowledge and skills of pregnant women. Several factors influence the participation of pregnant women in these classes. This research aimed to identify the factors that correlate with pregnant women’s participation in prenatal classes in several rural villages of Magetan Regency, Indonesia. This observational analytical research was performed quantitatively using a cross-sectional design. Seventy-eight pregnant women meeting the research criteria were included in this study. Data were collected through a questionnaire that has been tested through validity and reliability tests. A binary logistic regression was employed to conduct a statistical analysis. Results showed that supports from family (OR 32.40, p-value < 0.01, 95% CI 4.55–230.64) and from health workers (OR 22.53, p-value < 0.001, 95% CI 3.96–128.19) were significantly associated with the respondent’s participation in prenatal classes after controlling the potential confounding factors such as knowledge, attitudes and information availability. Keywords: maternal health, health promotion program, pregnancy, infant health

Sign in / Sign up

Export Citation Format

Share Document