Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional Study
ContextAdverse maternal outcomes and perinatal complications are associated with maternal hypothyroidism. However, the utility of levothyroxine (L-T4) in the treatment of pregnant women with hypothyroxinemia is unclear.ObjectiveThis study aimed to evaluate the effects of L-T4 on maternal and perinat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.874975/full |
| _version_ | 1811300434781929472 |
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| author | Guohua Li Yang Liu Xiujuan Su Shijia Huang Xiaosong Liu Qiaoling Du |
| author_facet | Guohua Li Yang Liu Xiujuan Su Shijia Huang Xiaosong Liu Qiaoling Du |
| author_sort | Guohua Li |
| collection | DOAJ |
| description | ContextAdverse maternal outcomes and perinatal complications are associated with maternal hypothyroidism. However, the utility of levothyroxine (L-T4) in the treatment of pregnant women with hypothyroxinemia is unclear.ObjectiveThis study aimed to evaluate the effects of L-T4 on maternal and perinatal outcomes in pregnant women with hypothyroxinemia.MethodsThe nonrandomized interventional study was conducted at Shanghai First Maternity and Infant Hospital, Punan Hospital of Shanghai, and Beicai Community Health Center of Shanghai. The pregnant women with hypothyroxinemia from the first trimester were enrolled and divided into treatment and control groups. 463 taking L-T4 and 501 not administering L-T4 were analyzed in the study. All participants were screened for TPOAB/TGAB antibody status.Main OutcomeThe primary outcome of the study was the hypertensive disorder of pregnancy (HDP), measured as the proportion of HDP. In addition to this primary outcome, some secondary outcomes will be measured: miscarriage, gestational diabetes mellitus, premature rupture of membranes, placental abruption, intrahepatic cholestasis of pregnancy, fetal distress, macrosomia, and neonates admitted to the neonatal intensive care unit (NICU). The effects of L-T4 on the incidence of adverse pregnancy outcomes and perinatal complications were compared.ResultsMultivariate logistic regression analysis showed that L-T4 treatment (adjusted odds ratio = 1.78 [95% CI = 1.00-3.16], p = 0.04) significantly reduced the incidence of miscarriage. Otherwise, lower neonates admitted to the NICU were strongly associated with the L-T4 group (adjusted odds ratio = 1.36 [95% CI = 1.01 – 1.83], p = 0.04). There were no significant differences in the incidence rates of other adverse maternal outcomes and perinatal complications between pregnant women with hypothyroxinemia receiving and those not receiving L-T4 treatment.ConclusionThe incidence of HDP was not significantly reduced using L-T4 in pregnant women with hypothyroxinemia. The results of this study also showed that L-T4 treatment significantly reduced the miscarriages rate and the proportion of newborns admitted to the NICU. |
| first_indexed | 2024-04-13T06:51:07Z |
| format | Article |
| id | doaj.art-32fdb7de2d4f4c4cb7619829dcb60c9e |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-13T06:51:07Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-32fdb7de2d4f4c4cb7619829dcb60c9e2022-12-22T02:57:23ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-04-011310.3389/fendo.2022.874975874975Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional StudyGuohua Li0Yang Liu1Xiujuan Su2Shijia Huang3Xiaosong Liu4Qiaoling Du5Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, ChinaClinical Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, ChinaDepartment of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, ChinaContextAdverse maternal outcomes and perinatal complications are associated with maternal hypothyroidism. However, the utility of levothyroxine (L-T4) in the treatment of pregnant women with hypothyroxinemia is unclear.ObjectiveThis study aimed to evaluate the effects of L-T4 on maternal and perinatal outcomes in pregnant women with hypothyroxinemia.MethodsThe nonrandomized interventional study was conducted at Shanghai First Maternity and Infant Hospital, Punan Hospital of Shanghai, and Beicai Community Health Center of Shanghai. The pregnant women with hypothyroxinemia from the first trimester were enrolled and divided into treatment and control groups. 463 taking L-T4 and 501 not administering L-T4 were analyzed in the study. All participants were screened for TPOAB/TGAB antibody status.Main OutcomeThe primary outcome of the study was the hypertensive disorder of pregnancy (HDP), measured as the proportion of HDP. In addition to this primary outcome, some secondary outcomes will be measured: miscarriage, gestational diabetes mellitus, premature rupture of membranes, placental abruption, intrahepatic cholestasis of pregnancy, fetal distress, macrosomia, and neonates admitted to the neonatal intensive care unit (NICU). The effects of L-T4 on the incidence of adverse pregnancy outcomes and perinatal complications were compared.ResultsMultivariate logistic regression analysis showed that L-T4 treatment (adjusted odds ratio = 1.78 [95% CI = 1.00-3.16], p = 0.04) significantly reduced the incidence of miscarriage. Otherwise, lower neonates admitted to the NICU were strongly associated with the L-T4 group (adjusted odds ratio = 1.36 [95% CI = 1.01 – 1.83], p = 0.04). There were no significant differences in the incidence rates of other adverse maternal outcomes and perinatal complications between pregnant women with hypothyroxinemia receiving and those not receiving L-T4 treatment.ConclusionThe incidence of HDP was not significantly reduced using L-T4 in pregnant women with hypothyroxinemia. The results of this study also showed that L-T4 treatment significantly reduced the miscarriages rate and the proportion of newborns admitted to the NICU.https://www.frontiersin.org/articles/10.3389/fendo.2022.874975/fulllevothyroxinehypothyroxinemiahypertensive disorder of pregnancymaternal outcomesmiscarriage |
| spellingShingle | Guohua Li Yang Liu Xiujuan Su Shijia Huang Xiaosong Liu Qiaoling Du Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional Study Frontiers in Endocrinology levothyroxine hypothyroxinemia hypertensive disorder of pregnancy maternal outcomes miscarriage |
| title | Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional Study |
| title_full | Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional Study |
| title_fullStr | Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional Study |
| title_full_unstemmed | Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional Study |
| title_short | Effect of Levothyroxine on Pregnancy Outcomes in Pregnant Women With Hypothyroxinemia: An Interventional Study |
| title_sort | effect of levothyroxine on pregnancy outcomes in pregnant women with hypothyroxinemia an interventional study |
| topic | levothyroxine hypothyroxinemia hypertensive disorder of pregnancy maternal outcomes miscarriage |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.874975/full |
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