Affiliation:
1. Department of Obstetrics and Gynecology McGill University Montreal Quebec Canada
2. The Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
3. Division of Endocrinology and Metabolism, Department of Medicine McGill University Health Centre Montreal Canada
4. Department of Obstetrics and Gynecology Western University London Ontario Canada
Abstract
AbstractObjectiveData are inconclusive regarding pregnancy complications associated with maternal chronic hypoparathyroidism. Therefore, we aimed to compare pregnancy, delivery and neonatal outcomes in patients affected by chronic hypoparathyroidism to those without chronic hypoparathyroidism.DesignA retrospective population‐based study utilising data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP‐NIS) database over 11 years from 2004 to 2014 inclusively. Multivariate logistic regression was used to control for confounders.PatientsPatients with chronic hypoparathyroidism compared with those without.MeasurementsObstetric and neonatal outcomes.ResultsWe identified 204 pregnancies in mothers with chronic hypoparathyroidism and 9,096,584 pregnancies without chronic hypoparathyroidism. After adjusting for age, insurance plan type, obesity, chronic hypertension, thyroid disease, pregestational diabetes mellitus, and previous caesarean section, patients in the hypoparathyroidism group, compared with those without hypoparathyroidism, were found to have an increased rate of preterm birth (<37 weeks) (19.1% vs. 7.2%, aOR: 2.49, 95% confidence interval [CI]: 1.74–3.54, p < 0.0001, respectively); and blood transfusions (4.9% vs. 1.0%, aOR: 4.07, 95% CI: 2.15–7.73, p < ‐0.0001). Neonates to mothers with chronic hypoparathyroidism had a higher rate of congenital anomalies (4.4% vs. 0.4%, aOR: 6.50, 95% CI: 3.31–12.75, p < 0.0001), with comparable rates of small‐for‐gestational‐age neonates and intrauterine foetal death.ConclusionThis is the largest study of chronic hypoparathyroidism in pregnancy to date. We found significant increases in the rates of preterm birth, blood transfusions and congenital anomalies in chronic hypoparathyroidism. Our findings highlight the importance of identifying chronic hypoparathyroidism as a risk factor for pregnancy and neonatal complications, although it remains unknown if maintaining calcium in the target range will mitigate these risks.
Subject
Endocrinology, Diabetes and Metabolism,Endocrinology
Reference24 articles.
1. A Population-Based Study of the Epidemiology of Chronic Hypoparathyroidism
2. Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus
3. Multiple Endocrine Neoplasia Type 1 Parathyroid Adenoma Development over Time
4. WhiteBAEndocrine and reproductive physiology: mosby physiology series. 5th edition. Elsevier; Google Search. 2018. Accessed July 17 2023.https://www.google.com/search?q=White+BA.+Endocrine+and+Reproductive+Physiology+Mosby+Physiology+Series.+5th+edition.+Elsevier+2018.&sxsrf=AB5stBgOcEtjWMdVm2a1Ebm7zE_GOqBJ_A%3A1689701254474&ei=hsu2ZKOuHIyk5NoPjuWt8AU&ved=0ahUKEwijibLY45iAAxUMElkFHY5yC14Q4dUDCA8&uact=5&oq=White+BA.+Endocrine+and+Reproductive+Physiology+Mosby+Physiology+Series.+5th+edition.+Elsevier+2018.&gs_lp=Egxnd3Mtd2l6LXNlcnAiZldoaXRlIEJBLiBFbmRvY3JpbmUgYW5kIFJlcHJvZHVjdGl2ZSBQaHlzaW9sb2d5OiBNb3NieSBQaHlzaW9sb2d5IFNlcmllcy4gNXRoIGVkaXRpb24uIEVsc2V2aWVyOyAyMDE4LkgAUABYAHAAeACQAQCYAQCgAQCqAQC4AQPIAQD4AQHiAwQYACBB&sclient=gws-wiz-serp
5. Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management