Management of Graves’ disease during pregnancy in the Poitou-Charentes Region

Hawken, Claire; Sarreau, Mélie; Bernardin, Marc; Delcourt, Anne-Christine; Muller, Anne; Lefort, G.; Pernollet, Patrice; Maréchaud, R.

doi:10.1016/j.ando.2016.03.003

Cited by 10 publications

(16 citation statements)

References 13 publications

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“…Thirty full-text articles were read in detail for eligibility and 18 articles were excluded for various reasons. Finally, 12 studies were included in this meta-analysis [ 6 – 8 , 13 – 21 ].…”

Section: Resultsmentioning

confidence: 99%

“…Tables 2 and 3 show the baseline data extracted from each study. The exposure groups included “MMI/CMZ,” “PTU,” or “MMI/CMZ and PTU.” Three studies involved a sample size in the exposure group that was less than or equal to 30 [ 16 , 20 , 21 ]. The definitions of “No ATD group” and “Control group” were slightly different in each included study (see Tables 2 and 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Effects of methimazole and propylthiouracil exposure during pregnancy on the risk of neonatal congenital malformations: A meta-analysis

Song

Lin²,

Chen

et al. 2017

PLoS ONE

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ObjectiveThe aim of this study was to determine the effect of exposure to different antithyroid drugs during pregnancy on the incidence of neonatal congenital malformations.MethodsA meta-analysis was performed to compare the incidence of neonatal congenital malformations after exposure to different antithyroid drugs during pregnancy. Twelve studies that met the inclusion criteria were included in this meta-analysis. PubMed, Embase, and CENTRAL databases were searched from inception until January 2017. Study designs included case–control studies, prospective cohort studies, and retrospective cohort studies.ResultsTwelve studies involving 8028 participants with exposure to different antithyroid drugs during pregnancy were included in this study; however, only 10 studies involving 5059 participants involved exposure to different antithyroid drugs exactly during pregnancy. Our results indicated that exposure to methimazole (MMI)/carbimazole (CMZ) only during pregnancy significantly increased the risk of neonatal congenital malformations compared to no antithyroid drug exposure (OR 1.88; 95%CI 1.33 to 2.65; P = 0.0004). No differences were observed between propylthiouracil (PTU) exposure and no antithyroid drug exposure only during pregnancy (OR 0.81; 95%CI 0.58 to 1.15; P = 0.24). Exposure to MMI/CMZ only during pregnancy significantly increased the risk of neonatal congenital malformations compared to that associated with exposure to PTU (OR 1.90; 95%CI 1.30 to 2.78; P = 0.001).ConclusionFor pregnant women with hyperthyroidism, exposure to MMI/CMZ significantly increased the incidence of neonatal congenital malformations compared to exposure to PTU and no antithyroid drug exposure; however, no differences were observed between PTU exposure and no antithyroid drug exposure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Effects of methimazole and propylthiouracil exposure during pregnancy on the risk of neonatal congenital malformations: A meta-analysis

Song

Lin²,

Chen

et al. 2017

PLoS ONE

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“…We identified 6 eligible articles, and 2 articles were excluded because the author couldn't be contacted for complete data [7,8] . Overall, 4 cohort studies published between 2014 and 2018 were included in the meta-analysis: 3 English articles were from PubMed database [9][10][11] and 1 Chinese article was from CNKI database [12] (Figure1). These studies involved a total of 480 patients (234 in the ATD group, 147…”

Section: Resultsmentioning

confidence: 99%

Comparative Safety of Therapies for Hyperthyroidism Planning Pregnancy: A Network Meta-analysis

Fang

Huang

Lin

et al. 2020

Preprint

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Objective: Our intention was to compare the pregnancy safety in women with hyperthyroidism seeking future pregnancy after ATD, RAI or thyroidectomy treatment and to explore the optimum treatment strategy. We hope the results will guide the choice for endocrinologists and patients, and be beneficial for promoting eugenics. Methods: We searched multiple databases though December 2019. The outcome indicators were abortion, preterm birth, IUGR and birth defect. We conducted a frequency-framework network meta-analysis by using Stata and R software. The results of the intervention comparison were expressed as OR with 95%CI, and ranking was assessed using surface under the cumulative ranking (SUCRA) probabilities. Results: The network meta-analysis included 4 retrospective cohort studies with a total enrollment of 480 patients. 1)Thyroidectomy had a lower risk of abortion than RAI [OR=0.77, 95%CI (0.23, 2.56)] and ATD [OR=0.68, 95%CI (0.21, 2.21)]. RAI had a lower risk of abortion than ATD [OR=0.88, 95%CI (0.45, 1.75)]. Based on SUCRA results, thyroidectomy (0.698) was followed by RAI (0.494), ATD (0.308). Thyroidectomy (60.7%) had the highest probability of being first compared to RAI (27.0%) and ATD (12.4%). 2)Thyroidectomy had a lower risk of preterm birth than RAI [OR=0.80, 95%CI (0.26, 2.44)] and ATD [OR=0.79, 95%CI (0.39, 1.59)]. RAI had a lower risk of preterm birth than ATD [OR=0.98, 95%CI (0.42, 2.33)]. Based on SUCRA results, thyroidectomy (0.703) was followed by RAI (0.430), ATD (0.367). Thyroidectomy (57.8%) had the highest probability of being first compared with RAI (30.5%) and ATD (11.8%). 3)Thyroidectomy had a lower risk of IUGR than RAI [OR=0.28, 95%CI (0.03, 3.02)] and ATD [OR=0.83, 95%CI (0.14, 4.86)]. RAI had a higher risk of IUGR than ATD [OR=3.02, 95%CI (0.60, 15.27)]. Based on SUCRA results, thyroidectomy (0.717) was followed by ATD (0.663), RAI (0.120). Thyroidectomy (56.6%) had the highest probability of being first compared with RAI (5.4%) and ATD (37.9%). 4)Thyroidectomy had a lower risk of birth defect than RAI [OR=0.70, 95%CI (0.02, 30.34)] and ATD [OR=0.23, 95%CI (0.01, 4.52)]. RAI had a lower risk of birth defect than ATD [OR=0.32, 95%CI (0.03, 3.12)] (Table 2). Based on SUCRA results, thyroidectomy (0.70) was followed by RAI (0.629), ATD (0.171). Thyroidectomy (55.9%) had the highest probability of being first compared with RAI (41.3%) and ATD (2.8%). Conclusion: Thyroidectomy was the optimum option for women with hyperthyroidism seeking near future pregnancy. The future research direction is to include more samples to conduct head-to-head randomized controlled trials or prospective cohort studies, establish inclusion criteria for various pre-pregnancy conditions or further subgroup analysis, and develop more acceptable, safer, and more manageable treatments that allow for the remission of both thyroid function and autoimmune abnormalities.

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“…5 A passagem transplacentária de anticorpos anti-receptor de TSH (TRAb) maternos pode causar bócio e hipotireoidismo fetal. 10 Este, tem ocorrência descrita em 1 a 2% das gestações de pacientes com doença de Graves. 1 Há associação em literatura da ocorrência de hipotireoidismo fetal e alterações em sistema nervoso central, ocorrência semelhante ao descrito em gestantes hipotireoideas.…”

Section: Resultsunclassified

Riscos E Benefícios Do Tratamento Do Hipertireoidismo Gestacional: Uma Atualização

Carbone¹,

Moro²,

Horiguchi³

et al. 2018

Blucher Medical Proceedings

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RESUMO:Objetivos: Avaliar os riscos, benefícios e como dar seguimento necessário às gestantes portadoras de hipertireoidismo, proporcionando melhor desfecho ao binômio materno fetal. Métodos:Foi realizada uma revisão da literatura na base de dados Pubmed, utilizando os descritores "pregnancy" AND "hiperthyreoidism" no período 2015 -2018. Foram selecionados 171 artigos e, após utilizar-se como fatores de exclusão as revisões bibliográficas, atingiu-se um total de 18 trabalhos relacionados ao tema.Resultados: Dentre as complicações gravídicas, o hipertireodismo está presente em 0,1-0,4% das gestações, sendo ocasionado, principalmente por Doença de Graves e Tireotoxicose Transitória da Gestação. Estudos revelam que a doença relaciona-se a risco elevado de pré-eclâmpsia, insuficiência cardíaca congestiva, arritmias cardíacas, diabetes mellitus gestacional e necrose hepática. Para o feto, há evidências de restrição de crescimento intrauterino, natimortalidade, abortamento e anomalias congênitas como malformações urinárias e cervicofaciais. Atualmente, drogas antitireóideas são recomendadas, embora também relacionadas a complicações. Conclusão: O diagnóstico precoce e o acompanhamento durante o pré-natal com o tratamento medicamentoso correto das gestantes com hipertireoidismo repercutem positivamente no desfecho gestacional, trazendo benefícios para o binômio materno fetal.

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Management of Graves’ disease during pregnancy in the Poitou-Charentes Region

Cited by 10 publications

References 13 publications

Effects of methimazole and propylthiouracil exposure during pregnancy on the risk of neonatal congenital malformations: A meta-analysis

Effects of methimazole and propylthiouracil exposure during pregnancy on the risk of neonatal congenital malformations: A meta-analysis

Comparative Safety of Therapies for Hyperthyroidism Planning Pregnancy: A Network Meta-analysis

Riscos E Benefícios Do Tratamento Do Hipertireoidismo Gestacional: Uma Atualização

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