Jewish General Hospital, McGill University, Obstetrics and Gynecology, Montreal, Canada.
Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, QC, Canada.
J Perinat Med. 2019 Sep 25;47(7):710-716. doi: 10.1515/jpm-2019-0039.
Background Thyroid cancer is one of the most common cancers in women of reproductive age. Our purpose was to evaluate the association between thyroid cancer and maternal and neonatal outcomes of pregnancy. Methods We conducted a retrospective cohort study using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS) database from the US. A cohort consisting of women who delivered between 1999 and 2014 was created. Multivariate logistic regression, controlling for baseline maternal characteristics, was used to compare pregnancy complications and neonatal outcomes of pregnant women with thyroid cancer [International Classification of Diseases, ninth edition (ICD-9) code 193] diagnosed before or during pregnancy with those of the obstetric population without thyroid cancer. Results The study included 14,513,587 pregnant women, of which 581 women had a diagnosis of thyroid cancer (4/100,000). During the observation period, there was an upward trend in the prevalence of thyroid cancer among pregnant women, though not statistically significant (P = 0.147). Women with thyroid cancer were more likely to be Caucasian, belong to a higher income quartile, have private insurance, to be discharged from an urban teaching hospital and to have pre-gestational hypertension. Women with thyroid cancer had a greater chance of delivering vaginally, requiring transfusion of blood and developing venous thromboembolism (VTE). Neonates of mothers with thyroid cancer were not found to be at increased risk for the adverse neonatal outcomes examined, specifically, congenital malformations, intrauterine growth restriction, fetal death and preterm labor. Conclusion Pregnancies complicated by thyroid cancer have higher incidences of VTE and need for transfusions, with comparable overall newborn outcomes.
甲状腺癌是育龄期女性最常见的癌症之一。我们的目的是评估甲状腺癌与妊娠的母婴结局之间的关系。
我们使用美国医疗保健成本和利用项目（HCUP-NIS）数据库进行了回顾性队列研究。创建了一个由 1999 年至 2014 年期间分娩的妇女组成的队列。使用多变量逻辑回归，控制基线产妇特征，比较患有甲状腺癌（国际疾病分类，第 9 版[ICD-9]代码 193）的孕妇与无甲状腺癌的产科人群的妊娠并发症和新生儿结局。
该研究纳入了 14513587 名孕妇，其中 581 名孕妇被诊断患有甲状腺癌（4/100000）。在观察期间，尽管没有统计学意义（P=0.147），但孕妇中甲状腺癌的患病率呈上升趋势。患有甲状腺癌的妇女更可能是白种人，属于更高的收入四分位数，拥有私人保险，从城市教学医院出院，患有孕前高血压。患有甲状腺癌的妇女更有可能经阴道分娩，需要输血，并发生静脉血栓栓塞（VTE）。患有甲状腺癌的母亲的新生儿未发现不良新生儿结局（特定为先天性畸形、宫内生长受限、胎儿死亡和早产）的风险增加。
患有甲状腺癌的妊娠并发症有更高的 VTE 和输血发生率，但总体新生儿结局相当。
