Turunen Suvi, Vääräsmäki Marja, Leinonen Maarit, Gissler Mika, Männistö Tuija, Suvanto Eila
Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland.
Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland.
Eur Thyroid J. 2021 Jun;10(3):230-236. doi: 10.1159/000515125. Epub 2021 Apr 6.
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.
The study data consisted of all singleton pregnancies ( = 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.
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%.
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.
甲状腺功能障碍影响着高达5% - 7%的所有妊娠。近年来，非妊娠人群中甲状腺激素的使用比例大幅上升。本研究的目的是评估孕妇中左甲状腺素替代治疗和抗甲状腺药物的使用随时间可能发生的变化。
研究数据包括2004年至2016年芬兰所有单胎妊娠（n = 736,873），数据来自芬兰医疗出生登记处。处方登记处和特殊退款权利登记处提供了左甲状腺素和抗甲状腺药物购买信息。通过探究左甲状腺素和抗甲状腺药物处方兑换的年率，来估计2004年至2016年甲状腺药物暴露率的变化。进行连接点回归分析，以探究左甲状腺素和抗甲状腺药物治疗的年际变化。
在研究期间，左甲状腺素的使用增加了五倍多；2004年，1.1%的孕妇接受左甲状腺素治疗，到2016年，患病率增至6.2%。此外，我们观察到孕期抗甲状腺药物使用略有增加，但孕期抗甲状腺药物的总体使用非常罕见。2004年，0.05%的孕妇使用抗甲状腺药物，到2016年，这一比例增至0.14%。
我们的研究表明，孕期左甲状腺素的使用比例显著增加。这表明对相关患者的追踪和筛查以及对孕期甲状腺疾病及其对妊娠结局的重要性的认识有所提高，治疗甲状腺疾病的阈值有所降低。
