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Risk factors for neonatal thyroid dysfunction in pregnancies complicated by Graves' disease.

Eur J Obstet Gynecol Reprod Biol. 2014 Jun;177:89-93. doi: 10.1016/j.ejogrb.2014.03.007. Epub 2014 Mar 21.

Uenaka M1, Tanimura K1, Tairaku S1, Morioka I2, Ebina Y1, Yamada H3.
1Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.2Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.3Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: yhideto@med.kobe-u.ac.jp.
Eur J Obstet Gynecol Reprod Biol
ABSTRACT
OBJECTIVE: To determine the factors related to adverse pregnancy outcomes and neonatal thyroid dysfunction in pregnancies complicated by Graves’ disease.STUDY DESIGN: Thirty-five pregnancies complicated by Graves’ disease were divided into two groups: adverse pregnancy outcome (n=15) and no adverse pregnancy outcome (n=20). Adverse pregnancy outcomes included spontaneous abortion, stillbirth, premature delivery, fetal growth restriction, and pregnancy-induced hypertension. The 31 pregnancies resulting in live births were also divided into two groups: neonatal thyroid dysfunction (n=9) and normal neonatal thyroid function (n=22). Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), TSH-receptor antibody (TRAb), the duration of hyperthyroidism in pregnancy, doses of antithyroid medication, and the duration of maternal antithyroid medication throughout pregnancy were compared.RESULTS: There were no significant differences in these factors between pregnancies with an adverse pregnancy outcome and those with no adverse pregnancy outcome. However, serum levels of FT4, TRAb, the duration of hyperthyroidism in pregnancy, the maximum daily dose of antithyroid medication, and the total dose of antithyroid medication were significantly different between pregnancies with neonatal thyroid dysfunction and those with normal neonatal thyroid function. Multivariate logistic regression analysis showed that the FT4 level in mothers was a significant factor related to the development of neonatal thyroid dysfunction (odds ratio 28.84, 95% confidence interval 1.65-503.62, p<0.05).CONCLUSION: Graves’ disease activity in women of childbearing age should be well controlled prior to conception.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:24726178 | http://www.ncbi.nlm.nih.gov/pubmed/24726178

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