Open AccessUse of thyroid hormones in relation to pregnancy: a Danish nationwide cohort study
Author(s) -
Gidén Karin,
Andersen Jon Trærup,
TorpPedersen Arendse Lærke,
Enghusen Poulsen Henrik,
TorpPedersen Christian,
JimenezSolem Espen
Publication year - 2015
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12621
Subject(s) - levothyroxine , medicine , pregnancy , medical prescription , obstetrics , cohort study , cohort , danish , pediatrics , gynecology , thyroid , linguistics , philosophy , genetics , pharmacology , biology
Objective To determine the rate of exposure of pregnant women to levothyroxine and to assess changes in these rates before, during and after pregnancy. Design Register‐based cohort study. Setting Danish nationwide registers. Population All women having a live birth in Denmark between 1 January 1997 and 31 December 2010 ( n = 912 342). Methods All pregnant women in the study period were identified from the Danish Medical Birth Register. Exposed women were identified from the Danish National Prescription Register, based on redemption of levothyroxine prescriptions before, during or after pregnancy. Main outcome measures The rate of pregnant women redeeming levothyroxine prescriptions and maternal characteristics. Results We identified a fourfold increase in levothyroxine prescription redemption during the study period, from 0.34% in 1997 to 1.39% by 2010. A mean of 0.79% of our cohort received levothyroxine. Most of the women who were using levothyroxine before pregnancy continued the therapy during their pregnancy, but 9.4% stopped redeeming their prescriptions. Overall, 0.28% of our cohort received a levothyroxine prescription for the first time within 9 months after pregnancy. Conclusions Fewer women than expected received levothyroxine treatment during pregnancy even though a fourfold increase was observed during the study period. Furthermore, one of 10 discontinued treatments during pregnancy. These findings all indicate that too few women are treated for hypothyroidism during pregnancy. Further research is needed to determine whether hypothyroid pregnant women are suboptimally treated and the possible consequences for the mother and fetus.