Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-13T01:09:53.666Z Has data issue: false hasContentIssue false
  • English
  • Français

Pregnancy outcomes in women with preexisting thyroid diseases: a French cohort study

Published online by Cambridge University Press:  10 December 2020

Marion Lecorguillé Open the ORCID record for Marion Lecorguillé [Opens in a new window] ,
Juliane Léger ,
Anne Forhan ,
Marie Cheminat ,
Marie-Noëlle Dufourg ,
Barbara Heude  and
Marie-Aline Charles
Marion Lecorguillé*
Affiliation:
Université de Paris, CRESS, INSERM, INRAE, F-75004Paris, France
Juliane Léger
Affiliation:
National Institute of Health and Medical Research (INSERM), UMR INSERM NeuroDiderot, DHU Protect, F-75019Paris, France Paris University, F-75019Paris, France Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Pediatric Endocrinology Diabetology Department, Reference Center for Growth and Development Endocrine Diseases, F-75019Paris, France
Anne Forhan
Affiliation:
Université de Paris, CRESS, INSERM, INRAE, F-75004Paris, France
Marie Cheminat
Affiliation:
Ined-Inserm-EFS joint Unit ELFE, Paris, France
Marie-Noëlle Dufourg
Affiliation:
Ined-Inserm-EFS joint Unit ELFE, Paris, France
Barbara Heude
Affiliation:
Université de Paris, CRESS, INSERM, INRAE, F-75004Paris, France
Marie-Aline Charles
Affiliation:
Université de Paris, CRESS, INSERM, INRAE, F-75004Paris, France Ined-Inserm-EFS joint Unit ELFE, Paris, France
*
Address for correspondence: Marion Lecorguillé, INSERM-CRESS U1153, Equipe 6 EARoH 16 avenue Paul Vaillant-Couturier 94807 Villejuif Cedex, F-75004Paris, France. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Women with thyroid diseases at the beginning of pregnancy may have suboptimal thyroid hormone levels because of potential difficulties in compensating for the physiological thyroid hormone changes occurring in pregnancy. Our objective was to study the association between preexisting thyroid diseases, pregnancy complications, and neonatal anthropometry. In total, 16,395 women from the ELFE French longitudinal birth cohort were included, and 273 declared pre-pregnancy thyroid diseases. Associations were investigated with multivariable regression models, with adjustment for relevant potential confounders. Body mass index (BMI) was additionally adjusted for in a second stage. As compared with other women, women with pre-pregnancy thyroid diseases were more frequently obese (19.6% vs. 9.8%) and had greater odds of gestational diabetes development (odds ratio [OR] = 1.58 [95% confidence interval [CI] 1.08, 2.30]) or had undergone treatment for infertility (OR = 1.57 [95% CI 1.07, 2.31]). After adjustment for BMI, the association with gestational diabetes was no longer significant (OR = 1.27 [95% CI 0.86, 1.88]). After excluding women with another medical history, those with pre-pregnancy thyroid diseases had increased odds of premature rupture of membranes (OR = 1.51 [95% CI 1.01, 2.25]). Children born from mothers with hypothyroidism before conception due to a disease or as a potential side effect of treatment had a smaller head circumference at birth than other children (β = −0.23 [95% CI −0.44, −0.01] cm). In conclusion, pre-pregnancy thyroid diseases were associated with risk of infertility treatment, gestational diabetes, and premature rupture of membranes. The association between history of hypothyroidism and moderate adverse effects on fetal head circumference growth needs replication.

Keywords

Medical historythyroid diseaseshypothyroidismpregnancy complications
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 12 , Issue 5 , October 2021 , pp. 704 - 713
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

MA Charles and B Heude contributed equally to this work.

References

Springer, D, Jiskra, J, Limanova, Z, Zima, T, Potlukova, E. Thyroid in pregnancy: from physiology to screening. Crit Rev Clin Lab Sci. 2017; 54(2), 102–116. doi: 10.1080/10408363.2016.1269309 CrossRefGoogle Scholar
Morreale de Escobar, G, Obregon, MJ, Escobar del Rey, F. Role of thyroid hormone during early brain development. Eur J Endocrinol. 2004; 151(Suppl 3), U25–U37.CrossRefGoogle ScholarPubMed
Korevaar, TIM, Chaker, L, Jaddoe, VWV, Visser, TJ, Medici, M, Peeters, RP. Maternal and birth characteristics are determinants of offspring thyroid function. J Clin Endocrinol Metab. 2016; 101(1), 206–213. doi: 10.1210/jc.2015-3559 CrossRefGoogle ScholarPubMed
Alexander, EK, Pearce, EN, Brent, GA, et al. 2017 guidelines of the American thyroid association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017; 27(3), 315–389. doi: 10.1089/thy.2016.0457 CrossRefGoogle ScholarPubMed
Léger, J, dos Santos, S, Larroque, B, Ecosse, E. Pregnancy outcomes and relationship to treatment adequacy in women treated early for congenital hypothyroidism: a longitudinal population-based study. J Clin Endocrinol Metab. 2015; 100(3), 860–869. doi: 10.1210/jc.2014-3049 CrossRefGoogle ScholarPubMed
Dong, A, Stagnaro-Green, A. Differences in diagnostic criteria mask the true prevalence of thyroid disease in pregnancy - a systematic review and meta-analysis. Thyroid Off J Am Thyroid Assoc. November 2018. doi: 10.1089/thy.2018.0475 Google ScholarPubMed
Korevaar, TIM, Medici, M, Visser, TJ, Peeters, RP. Thyroid disease in pregnancy: new insights in diagnosis and clinical management. Nat Rev Endocrinol. 2017; 13(10), 610–622. doi: 10.1038/nrendo.2017.93 CrossRefGoogle ScholarPubMed
Casey, BM, Dashe, JS, Wells, CE, et al. Subclinical Hypothyroidism and Pregnancy Outcomes: Obstet Gynecol. 2005; 105(2), 239–245. doi: 10.1097/01.AOG.0000152345.99421.22 CrossRefGoogle ScholarPubMed
Nazarpour, S, Ramezani Tehrani, F, Simbar, M, Azizi, F. Thyroid dysfunction and pregnancy outcomes. Iran J Reprod Med. 2015; 13(7), 387–396.Google ScholarPubMed
Teng, W, Shan, Z, Patil-Sisodia, K, Cooper, DS. Hypothyroidism in pregnancy. Lancet Diabetes Endocrinol. 2013; 1(3), 228–237. doi: 10.1016/S2213-8587(13)70109-8 CrossRefGoogle ScholarPubMed
Maraka, S, Ospina, NMS, O’Keeffe, DT, et al. Subclinical hypothyroidism in pregnancy: a systematic review and meta-analysis. Thyroid. 2016; 26(4), 580–590. doi: 10.1089/thy.2015.0418 CrossRefGoogle ScholarPubMed
Krassas, GE. Thyroid disease and female reproduction. Fertil Steril. 2000; 74(6), 1063–1070.CrossRefGoogle ScholarPubMed
Cleary-Goldman, J, Malone, FD, Lambert-Messerlian, G, et al. Maternal Thyroid Hypofunction and Pregnancy Outcome: Obstet Gynecol. 2008; 112(1), 85–92. doi: 10.1097/AOG.0b013e3181788dd7 CrossRefGoogle ScholarPubMed
Männistö, T, Mendola, P, Grewal, J, Xie, Y, Chen, Z, Laughon, SK. Thyroid Diseases and Adverse Pregnancy Outcomes in a Contemporary US Cohort. J Clin Endocrinol Metab. 2013; 98(7), 2725–2733. doi: 10.1210/jc.2012-4233 CrossRefGoogle Scholar
Hou, J, Yu, P, Zhu, H, et al. The impact of maternal hypothyroidism during pregnancy on neonatal outcomes: a systematic review and meta-analysis. Gynecol Endocrinol. 2016; 32(1), 9–13. doi: 10.3109/09513590.2015.1104296 CrossRefGoogle ScholarPubMed
De Leo, S, Pearce, EN. Autoimmune thyroid disease during pregnancy. Lancet Diabetes Endocrinol. 2018; 6(7), 575–586. doi: 10.1016/S2213-8587(17)30402-3 CrossRefGoogle ScholarPubMed
Karakosta, P, Alegakis, D, Georgiou, V, et al. Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. J Clin Endocrinol Metab. 2012; 97(12), 4464–4472. doi: 10.1210/jc.2012-2540 CrossRefGoogle ScholarPubMed
Cooper, DS, Laurberg, P. Hyperthyroidism in pregnancy. Lancet Diabetes Endocrinol. 2013; 1(3), 238–249. doi: 10.1016/S2213-8587(13)70086-X CrossRefGoogle ScholarPubMed
Laurberg, P, Bournaud, C, Karmisholt, J, Orgiazzi, J. Management of Graves’ hyperthyroidism in pregnancy: focus on both maternal and foetal thyroid function, and caution against surgical thyroidectomy in pregnancy. Eur J Endocrinol. 2009; 160(1), 1–8. doi: 10.1530/EJE-08-0663 CrossRefGoogle ScholarPubMed
Phoojaroenchanachai, M, Sriussadaporn, S, Peerapatdit, T, et al. Effect of maternal hyperthyroidism during late pregnancy on the risk of neonatal low birth weight. Clin Endocrinol (Oxf). 2001; 54(3), 365–370.CrossRefGoogle ScholarPubMed
van den Boogaard, E, Vissenberg, R, Land, JA, et al. Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update. 2011; 17(5), 605–619. doi: 10.1093/humupd/dmr024 CrossRefGoogle ScholarPubMed
Thangaratinam, S, Tan, A, Knox, E, Kilby, MD, Franklyn, J, Coomarasamy, A. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ. 2011; 342(may09 1), d2616–d2616. doi: 10.1136/bmj.d2616 CrossRefGoogle ScholarPubMed
Hirsch, D, Levy, S, Nadler, V, Kopel, V, Shainberg, B, Toledano, Y. Pregnancy outcomes in women with severe hypothyroidism. Eur J Endocrinol. 2013; 169(3), 313–320. doi: 10.1530/EJE-13-0228 CrossRefGoogle ScholarPubMed
Reid, SM, Middleton, P, Cossich, MC, Crowther, CA, Bain, E. Interventions for clinical and subclinical hypothyroidism pre-pregnancy and during pregnancy. Cochrane Database Syst Rev. 2013; (5), CD007752. doi: 10.1002/14651858.CD007752.pub3 Google ScholarPubMed
Earl, R, Crowther, CA, Middleton, P. Interventions for hyperthyroidism pre-pregnancy and during pregnancy. Cochrane Database Syst Rev. 2013; (11), CD008633. doi: 10.1002/14651858.CD008633.pub3 Google ScholarPubMed
Charles, MA, Thierry, X, Lanoe, J-L, et al. Cohort profile: the French National cohort of children ELFE: birth to 5 years. Int J Epidemiol. November 2019. doi: 10.1093/ije/dyz227 Google Scholar
Ego, A, Prunet, C, Blondel, B, Kaminski, M, Goffinet, F, Zeitlin, J. Customized and non-customized French intrauterine growth curves. II - Comparison with existing curves and benefits of customization. J Gynecol Obstet Biol Reprod (Paris). 2016; 45(2), 165–176. doi: 10.1016/j.jgyn.2015.08.008 CrossRefGoogle ScholarPubMed
Léger, J, Ecosse, E, Roussey, M, Lanoë, JL, Larroque, B, French Congenital Hypothyroidism Study Group. Subtle health impairment and socioeducational attainment in young adult patients with congenital hypothyroidism diagnosed by neonatal screening: a longitudinal population-based cohort study. J Clin Endocrinol Metab. 2011; 96(6), 1771–1782. doi: 10.1210/jc.2010-2315 CrossRefGoogle ScholarPubMed
Catalano, PM, Shankar, K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ. 2017; 356, j1. doi: 10.1136/bmj.j1 CrossRefGoogle ScholarPubMed
Iwen, KA, Schröder, E, Brabant, G. Thyroid hormones and the metabolic syndrome. Eur Thyroid J. 2013; 2(2), 83–92. doi: 10.1159/000351249 CrossRefGoogle ScholarPubMed
Chen, L-M, Du, W-J, Dai, J, et al. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: a single-center cohort study of a Chinese population. Gao C-Q, ed. PLoS ONE. 2014; 9(10), e109364. doi: 10.1371/journal.pone.0109364 CrossRefGoogle Scholar
Blazer, S, Moreh-Waterman, Y, Miller-Lotan, R, Tamir, A, Hochberg, Z. Maternal hypothyroidism may affect fetal growth and neonatal thyroid function. Obstet Gynecol. 2003; 102(2), 232–241.Google ScholarPubMed
Su, P-Y, Huang, K, Hao, J-H, et al. Maternal thyroid function in the first twenty weeks of pregnancy and subsequent fetal and infant development: a prospective population-based cohort study in China. J Clin Endocrinol Metab. 2011; 96(10), 3234–3241. doi: 10.1210/jc.2011-0274 CrossRefGoogle ScholarPubMed
Männistö, T, Vääräsmäki, M, Pouta, A, et al. Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population-based cohort study. J Clin Endocrinol Metab. 2009; 94(3), 772–779. doi: 10.1210/jc.2008-1520 CrossRefGoogle ScholarPubMed
Korevaar, TIM, Muetzel, R, Medici, M, et al. Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study. Lancet Diabetes Endocrinol. 2016; 4(1), 35–43. doi: 10.1016/S2213-8587(15)00327-7 CrossRefGoogle ScholarPubMed
Lundgren, EM, Cnattingius, S, Jonsson, B, Tuvemo, T. Intellectual and psychological performance in males born small for gestational age with and without catch-up growth. Pediatr Res. 2001; 50(1), 91–96. doi: 10.1203/00006450-200107000-00017 CrossRefGoogle ScholarPubMed
Henrichs, J, Bongers-Schokking, JJ, Schenk, JJ, et al. Maternal thyroid function during early pregnancy and cognitive functioning in early childhood: the generation R study. J Clin Endocrinol Metab. 2010; 95(9), 4227–4234. doi: 10.1210/jc.2010-0415 CrossRefGoogle ScholarPubMed
Pop, VJ, Brouwers, EP, Vader, HL, Vulsma, T, van Baar, AL, de Vijlder, JJ. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin Endocrinol (Oxf). 2003; 59(3), 282–288.CrossRefGoogle ScholarPubMed
Levie, D, Korevaar, TIM, Bath, SC, et al. Association of maternal iodine status with child IQ: a meta-analysis of individual participant data. J Clin Endocrinol Metab. 2019; 104(12), 5957–5967. doi: 10.1210/jc.2018-02559 CrossRefGoogle ScholarPubMed
Haddow, JE. Maternal thyroxine and fetal brain development: the latest chapter, a look back, and considerations for the future. J Clin Endocrinol Metab. 2013; 98(4), 1388–1390. doi: 10.1210/jc.2013-1646 CrossRefGoogle ScholarPubMed
Korevaar, TIM, Tiemeier, H, Peeters, RP. Clinical associations of maternal thyroid function with fetal brain development:Epidemiological interpretation and overview of available evidence. Clin Endocrinol (Oxf). April 2018. doi: 10.1111/cen.13724 CrossRefGoogle Scholar
Supplementary material: File

Lecorguillé et al. supplementary material

Lecorguillé et al. supplementary material

Download Lecorguillé et al. supplementary material(File)
File 32.1 KB