Department of Obstetrics and Gynecology, Mcgill University, Montreal, Québec, Canada.
Department of Obstetrics and Gynecology, Western University, London, Ontario, Canada.
Clin Endocrinol (Oxf). 2022 Sep;97(3):347-354. doi: 10.1111/cen.14713. Epub 2022 Mar 16.
Large population-based studies on maternal hyperthyroidism's effect on antepartum, intrapartum, and neonatal complications are few. Most of these studies were small or did not evaluate a broad scope of possible complications. Therefore, a large population-based cohort study was conducted to study the associations between maternal hyperthyroidism and pregnancy and perinatal complications.
This is a retrospective population-based cohort study utilizing data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample over 11 years from 2004 to 2014.
16,984 deliveries to women with hyperthyroidism and 9,079,804 deliveries to mothers who did not suffer of hyperthyroidism.
A cohort of all deliveries between 2004 and 2014 inclusively was created. Within this group, all deliveries to women with hyperthyroidism were the study group (n = 16,984) and the remaining deliveries were categorized as nonhyperthyroidism births and comprised the reference group (n = 9,079,804). The main outcome measures were pregnancy and perinatal complications.
Maternal hyperthyroidism was associated with several pregnancy and perinatal complications, including increased risks of gestational hypertension (adjusted odds ratio [aOR]: 1.236, 95% confidence interval [CI]: 1.045-1.462, p = .013) and preeclampsia (aOR: 1.190, 95% CI: 1.006-1.408, p = .042). These patients are more likely to experience preterm premature rupture of membranes (aOR: 1.322, 95% CI: 1.007-1.735, p = .044), preterm delivery (aOR: 1.287 95% CI: 1.132-1.465, p < .001), placental previa (aOR: 1.527, 95% CI: 1.082-2.155, p = .016), and suffer from venous thromboembolism (aOR: 2.894, 95% CI: 1.293-6.475, p = .010). As for neonatal outcomes, small for gestational age and stillbirth were more likely to occur in the offspring of women with hyperthyroidism (aOR: 1.688, 95% CI: 1.437-1.984, p < .001 and aOR: 1.647, 95% CI: 1.109-2.447, p = .013, respectively).
Women with hyperthyroidism are more likely to experience pregnancy, delivery, and neonatal complications. We found an association between hyperthyroidism and hypertensive disorders, preterm delivery, and intrauterine fetal death.
关于母体甲状腺功能亢进对产前、产时和新生儿并发症影响的大规模基于人群的研究较少。这些研究大多规模较小，或者没有评估可能存在的并发症的广泛范围。因此，进行了一项大规模基于人群的队列研究，以研究母体甲状腺功能亢进与妊娠和围产期并发症之间的关系。
这是一项回顾性基于人群的队列研究，利用了 2004 年至 2014 年期间医疗保健成本和利用项目-全国住院患者样本 11 年来的数据。
16984 例患有甲状腺功能亢进的妇女分娩和 9079804 例未患甲状腺功能亢进的母亲分娩。
创建了一个 2004 年至 2014 年期间所有分娩的队列。在该组中，所有患有甲状腺功能亢进的妇女分娩都属于研究组（n=16984），其余分娩被归类为非甲状腺功能亢进分娩，属于对照组（n=9079804）。主要结局指标是妊娠和围产期并发症。
母体甲状腺功能亢进与多种妊娠和围产期并发症相关，包括妊娠高血压（调整后优势比[aOR]：1.236，95%置信区间[CI]：1.045-1.462，p=0.013）和子痫前期（aOR：1.190，95% CI：1.006-1.408，p=0.042）风险增加。这些患者更有可能出现早产胎膜早破（aOR：1.322，95% CI：1.007-1.735，p=0.044）、早产（aOR：1.287，95% CI：1.132-1.465，p<0.001）、前置胎盘（aOR：1.527，95% CI：1.082-2.155，p=0.016）和静脉血栓栓塞（aOR：2.894，95% CI：1.293-6.475，p=0.010）。对于新生儿结局，甲状腺功能亢进妇女的后代更有可能出现小于胎龄儿和死胎（aOR：1.688，95% CI：1.437-1.984，p<0.001 和 aOR：1.647，95% CI：1.109-2.447，p=0.013）。
患有甲状腺功能亢进的妇女更容易发生妊娠、分娩和新生儿并发症。我们发现甲状腺功能亢进与高血压疾病、早产和宫内胎儿死亡之间存在关联。
