Thyroid Laboratory Testing and Management in Women on Thyroid Replacement Before Pregnancy and Associated Pregnancy Outcomes
| Autor: | Patricia Lemieux, Jennifer M. Yamamoto, Amy Metcalfe, Kara Nerenberg, Alex Chin, Lois E. Donovan, Rshmi Khurana |
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| Rok vydání: | 2021 |
| Předmět: |
endocrine system diseases
pregnancy outcomes Endocrinology Diabetes and Metabolism Thyrotropin Thyroid Function Tests Alberta 0302 clinical medicine Endocrinology Pregnancy Medicine Euthyroid Practice Patterns Physicians' thyroid and pregnancy medicine.diagnostic_test Obstetrics Thyroid Pregnancy Outcome Gestational age medicine.anatomical_structure Pregnancy and Fetal Development 030220 oncology & carcinogenesis Premature Birth Gestation Female Preconception Care hormones hormone substitutes and hormone antagonists medicine.drug Adult endocrine system medicine.medical_specialty Hormone Replacement Therapy Levothyroxine Gestational Age 030209 endocrinology & metabolism Thyroid function tests 03 medical and health sciences Hypothyroidism Intensive Care Units Neonatal Humans Retrospective Studies Dose-Response Relationship Drug overtreatment business.industry Infant Newborn Retrospective cohort study medicine.disease Pregnancy Complications Thyroxine business |
| Zdroj: | Thyroid |
| ISSN: | 1557-9077 1050-7256 |
| Popis: | Background: Women with hypothyroidism before pregnancy often require an increase in their levothyroxine dosage to maintain a euthyroid state during pregnancy. The objectives of this study were to investigate: (i) the frequency and distribution of thyrotropin (TSH) testing and levothyroxine dosage adjustment by gestational age, (ii) the magnitude of levothyroxine increase by the underlying etiology of hypothyroidism, and (iii) the relationship of overtreatment or undertreatment during pregnancy with adverse pregnancy outcomes among women using thyroid replacement before pregnancy. Methods: A retrospective cohort study of pregnancies in women on thyroid replacement before pregnancy in Alberta, Canada, was performed. Women using thyroid replacement anytime during the two years before pregnancy who delivered between October 2014 and September 2017 were included. Delivery records, physician billing, and laboratory and pharmacy administrative data were linked. Outcomes included characteristics of TSH testing, levothyroxine dosing, and pregnancy outcomes. The frequency and gestational timing of TSH testing and levothyroxine adjustments were calculated. Multiple logistic regression was used to test whether pregnancies with TSH |
| Databáze: | OpenAIRE |
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