Wikner Birgitta Norstedt, Sparre Lottie Skjöldebrand, Stiller Carl-Olav, Källén Bengt, Asker Charlotte
Department of Medicine, Karolinska Institutet, Clinical Pharmacology Unit, Karolinska University Hospital, Stockholm, Solna, Sweden.
Acta Obstet Gynecol Scand. 2008;87(6):617-27. doi: 10.1080/00016340802075103.
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.
Register study based on prospectively collected data in relation to delivery.
Swedish Health Registers.
All pregnant women (n=848,468) and all infants born (n=861,989) in Sweden from 1 July 1995 to 31 December 2004.
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.
Neonatal outcome, malformations and maternal characteristics. Data were analyzed with adjustments for identified confounders.
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.
Women on thyroid substitution during pregnancy had an increased risk for some pregnancy complications, but their infants were only slightly affected.
描述接受甲状腺激素替代治疗的女性所生婴儿的新生儿结局，包括先天性畸形的情况，以及这些女性的母体特征。
基于前瞻性收集的分娩相关数据进行的登记研究。
瑞典健康登记处。
1995年7月1日至2004年12月31日期间在瑞典的所有孕妇（n = 848,468）和所有出生婴儿（n = 861,989）。
从瑞典医学出生登记处识别出在孕早期报告使用甲状腺激素或在孕晚期获得甲状腺激素处方的女性（n = 9,866）及其婴儿（n = 10,055）。参考人群包括同一时间段内所有分娩的女性及其后代。
新生儿结局、畸形和母体特征。对已识别的混杂因素进行调整后分析数据。
与参考人群中的女性相比，使用甲状腺素的女性发生先兆子痫、糖尿病（既往或妊娠期）、剖宫产和引产的发生率更高。早产风险略有增加（比值比1.13，95%置信区间1.03 - 1.25）。在8名婴儿中发现了新生儿甲状腺疾病（7名患有甲状腺毒症，1名未明确），预期数量为0.2。在新生儿诊断中未发现其他异常。发现先天性畸形的风险虽小但具有统计学意义（比值比 = 1.14，95%置信区间1.05 - 1.26）。
孕期接受甲状腺替代治疗的女性发生某些妊娠并发症的风险增加，但其婴儿仅受到轻微影响。
