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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]
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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
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Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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Footnotes

*

MA Charles and B Heude contributed equally to this work.

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