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The effects of gestational transient thyrotoxicosis on the perinatal outcomes: a case–control study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To study the effects of gestational transient thyrotoxicosis (GTT) on pregnancy outcomes.

Methods

This case–control study retrospectively analyzed 7976 women with singleton pregnancies whose thyroid function was measured before 16 weeks of gestation and who delivered at ≥22 weeks of pregnancy. GTT was defined as hyperthyroidism (free thyroxine [FT4] level: ≥95th percentile) in the early pregnancy, which normalized in mid-pregnancy without thyroid-stimulating hormone receptor antibodies. Using data extracted from electronic records, we examined the association between GTT and the pregnancy outcomes (preterm delivery, gestational age at delivery, pregnancy induced hypertension (PIH), preeclampsia, placental abruption, caesarian section, birth weight, low birth weight, Apgar score, cord pH, stillbirth at gestational week ≥22, and neonatal death). We classified the cases into quartiles according to their FT4 values during the early pregnancy and investigated the association with the gestational age at delivery.

Results

Two hundred and eight cases of GTT and 6317 cases with normal thyroid assessments were reviewed. GTT was associated with hyperemesis gravidarum, but not with stillbirth, preterm delivery, PIH, preeclampsia, placental abruption, or low birth weight. The gestation period was shorter in patients with GTT than in those with a normal thyroid function (38.69 ± 1.79 vs. 39.07 ± 1.64 weeks, p < 0.01). Higher FT4 levels during the early pregnancy were associated with earlier delivery (p = 0.02).

Conclusions

GTT was associated with a lower gestational age at delivery but not with adverse pregnancy outcomes. There was a negative correlation between the FT4 values in the early pregnancy and the gestational period.

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Acknowledgments

We would like to thank Dr. Julian Tang of the Department of Education for Clinical Research, National Center for Child Health and Development, for proofreading, editing, and rewriting parts of this manuscript.

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Authors and Affiliations

  1. Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan

    Satoko Kinomoto-Kondo, Nagayoshi Umehara, Shiori Sato, Kohei Ogawa, Naoko Arata & Haruhiko Sago

  2. Department of Social Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan

    Takeo Fujiwara

Authors
  1. Satoko Kinomoto-Kondo
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  2. Nagayoshi Umehara
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  3. Shiori Sato
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  4. Kohei Ogawa
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  5. Takeo Fujiwara
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  6. Naoko Arata
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  7. Haruhiko Sago
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Corresponding author

Correspondence to Nagayoshi Umehara.

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Funding

The authors received no funding for this study.

Conflict of interest

All of the authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Data were collected without any personal identifiers of the study participants, so individual informed consent was considered not necessary and was not obtained. All data were anonymized and de-identified prior to analysis. If the study participants disagreed with this study, they could choose an opt-out. The institution review boards of National Center for Child Health and Development approved this study protocol (No. 80, approved at November 27, 2014).

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Kinomoto-Kondo, S., Umehara, N., Sato, S. et al. The effects of gestational transient thyrotoxicosis on the perinatal outcomes: a case–control study. Arch Gynecol Obstet 295, 87–93 (2017). https://doi.org/10.1007/s00404-016-4219-2

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  • DOI: https://doi.org/10.1007/s00404-016-4219-2

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