Premium
Thyroid function control among pregnant women following a therapeutic thyroidectomy
Author(s) -
Horowitz Gilad,
IshShalom Maya,
Warshavsky Anton,
Stern Naftali,
Fliss Dan M.,
Comaneshter Doron,
Vinker Shlomo
Publication year - 2021
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13687
Subject(s) - medicine , thyroidectomy , retrospective cohort study , thyroid disease , thyroid function , thyroid , obstetrics , pregnancy , cohort study , multivariate analysis , cohort , thyroid function tests , gynecology , surgery , biology , genetics
Objectives The aim of this study was to assess the extent of thyroid function control among pregnant women who had previously undergone a therapeutic thyroidectomy. Design Retrospective cohort study. Setting The largest health maintenance organization in Israel. Participants All female patients who were pregnant between May, 2001 and September, 2012 and had a medical history of thyroid surgery. Main outcome measure The thyroid‐stimulating hormone (TSH) levels throughout the pregnancy were compared to recommended trimestral values. A multivariate analysis was performed to determine risk factors for not attaining TSH recommended range. Results A total of 477 females with a history of thyroid surgery had given 701 births during the study period. Forty‐three percent (n = 203), had thyroidal malignancy. Nearly half of the women underwent total thyroidectomy (43.4%, n = 207). The women’s TSH values were within the recommended range in only 60% (n = 350) of the pregnancies during the first trimester (0.1‐2.5 mIU/L), in 61% (n = 335) during the second trimester (0.2‐3 mIU/L), and in 70% (n = 338) during the third trimester (0.3‐3 mIU/L). In multivariate analysis, women that underwent a total thyroidectomy due to a benign thyroid disease, were at the highest risk for not attaining target TSH levels. Conclusions This very large cohort of pregnant women with a past history of thyroid surgery demonstrated a significant percentage of pregnancies with TSH values above the recommended range. Women that underwent a total thyroidectomy due to benign thyroid disease were at the highest risk for gestational hypothyroidism.