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Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism
L K Millar1, D A Wing, A S Leung
1Department of Obstetrics and Gynecology, Los Angeles County + University of Southern California Medical Center, Women's Hospital.
Objective:
To determine whether control of hyperthyroidism during pregnancy reduces the risk of low birth weight infants and severe preeclampsia.
Methods:
Labor, delivery, and postpartum records of 181 hyperthyroid women were reviewed for maternal and fetal outcomes. Subjects were separated into three groups based on their thyroid status: controlled (n = 34), including women who were euthyroid at presentation and delivery; controlled during pregnancy (n = 90), including women who were hyperthyroid at presentation and euthyroid at delivery; and uncontrolled (n = 57), including women who were hyperthyroid at presentation and delivery.
Results:
The risk of low birth weight infants was 0.74 (95% confidence interval [CI] 0.18-3.08) among controlled women, 2.36 (95% CI 1.36-4.12) among women who were controlled during pregnancy, and 9.24 (95% CI 5.47-15.6) among women who were uncontrolled during pregnancy compared to the incidence among nonhyperthyroid mothers. The risk of severe preeclampsia was significantly higher (odds ratio 4.74, 95% CI 1.14-19.7) among uncontrolled women compared with those who were controlled during their pregnancies. Elevated TSH-receptor antibody levels were not related to preeclampsia. Maternal thioamide therapy did not adversely affect neonatal outcomes.
Conclusion:
Lack of control of hyperthyroidism significantly increases the risk of low birth weight infants and severe preeclampsia.