Congenital Anomalies in Children Exposed to Antithyroid Drugs In-Utero: A Meta-Analysis of Cohort Studies

Abstract

BackgroundHyperthyroidism affects about 0.2%-2.7% of all pregnancies, and is commonly managed with antithyroid drugs (ATDs). However, previous studies about the effects of ATDs on congenital anomalies are controversial. Therefore, the present meta-analysis was performed to explore the risk of congenital anomalies in children exposed to ATDs in-utero.MethodsEmbase, Pubmed, Web of Knowledge, and BIOSIS Citation Index were searched to find out studies about congenital anomalies in children exposed to ATDs in-utero reported up to May 2014. The references cited by the retrieved articles were also searched. The relative risks (RRs) and confidence intervals (CIs) for the individual studies were pooled by fixed effects models, and heterogeneity was analyzed by chi-square and I 2 tests.ResultsEight studies met the inclusion criteria. Exposure to propylthiouracil (PTU), methimazole/carbimazole (MMI/CMZ), and PTU & MMI/CMZ was investigated in 7, 7 and 2 studies, respectively. The pooled RR was 1.20 (95%CI: 1.02-1.42), 1.64 (95%CI: 1.39-1.92), and 1.83 (95%CI: 1.30-2.56) for congenital anomalies after exposure to PTU, MMI/CMZ, and PTU & MMI/CMZ, respectively.ConclusionsThe meta-analysis suggests that exposure to ATDs in-utero increases the risk of congenital anomalies. The use of ATDs in pregnancy should be limited when possible. Further research is needed to delineate the exact teratogenic risk for particular congenital anomaly.

Antithyroid Drug Use in Pregnancy and Birth Defects: Why Some Studies Find Clear Associations, and Some Studies Report None

“…The conclusions of the present review are in line with the results of a new meta-analysis published by Chinese analysts (18).…”

Comparison between radioiodine therapy and single‐session radiofrequency ablation of autonomously functioning thyroid nodules: A retrospective study

“…The main disadvantage of RI is the conception delayed at least for 6 months; as to ATDs, they resolve the symptoms, but, when discontinued, the reappearance of the disease is certain. Moreover, due to the ATDs capability to cross the placenta, as well as to modulate foetal thyroid function, the pursuance of this therapy during pregnancy is to be avoided . In both male and female young patients, the RI therapy exposes them to radiation; the administered 15 mCi dose of 131 I to young men showed a reduced sperm motility, which can, therefore, determine infertility in subjects at risk .…”

A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors

“…Recently, most studies have focused on the identification of risk factors of NSCL/P. Many epidemiological studies have confirmed that maternal age [10–12], maternal educational level [2, 13], family income [13, 14], abnormal reproductive histories [15], family history [14–16], history of infection during pregnancy [17], medication use during pregnancy [18, 19], ambient environment pollution [20], parental occupational hazards exposure [21–23], maternal nutrient intake [23–26], and maternal lifestyle factors (alcohol drinking, smoking) [27–29] are associated with NSCL/P. However, an individual risk prediction tool for NSCL/P has not been reported.…”