Hyperthyroidism in Danish Pregnant Women During a 20-Year Period

Author:

Uldall Torp Nanna Maria12ORCID,Liew Zeyan34ORCID,Carlé Allan25,Karmisholt Jesper25,Pedersen Inge Bülow25,Andersen Stig26,Andersen Stine Linding12

Affiliation:

1. Department of Clinical Biochemistry, Aalborg University Hospital , 9000 Aalborg , Denmark

2. Department of Clinical Medicine, Aalborg University , 9000 Aalborg , Denmark

3. Department of Environmental Health Sciences, Yale School of Public Health , New Haven, CT 06510 , USA

4. Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health , New Haven, CT 06510 , USA

5. Department of Endocrinology, Aalborg University Hospital , 9000 Aalborg , Denmark

6. Department of Geriatrics, Aalborg University Hospital , 9000 Aalborg , Denmark

Abstract

Abstract Context Hyperthyroidism in pregnancy is a clinical concern, and surveillance of any change in the occurrence of hyperthyroidism in pregnancy is important, especially when a mandatory iodine fortification (IF) program is implemented such as in Denmark in the year 2000. Objective To investigate any change in the occurrence of hyperthyroidism and the use of antithyroid drugs (ATDs) in Danish pregnant women during a 20-year period before and after the implementation of IF. Methods A nationwide register-based cohort (1997-2016) and 2 birth cohorts with biochemical data (the Danish National Birth Cohort, 1997-2003, and the North Denmark Region Pregnancy Cohort, 2011-2015) were used to study maternal use of ATDs in pregnancy and frequency of early pregnancy biochemical hyperthyroidism during a 20-year period prior to and after the implementation of mandatory IF. Results In the nationwide cohort, the adjusted odds ratio (aOR) for treatment with ATDs was 1.51 (95% CI, 1.30-1.74) after mandatory IF (2001-2004) compared with baseline (1997-1999). The increase was more pronounced in the previously moderately iodine-deficient West Denmark (aOR 1.67; 95% CI, 1.36-2.04) than the mildly deficient East Denmark (aOR 1.30; 95% CI, 1.06-1.60) and returned to baseline levels at the end of follow-up in both regions. No time-related difference in early pregnancy biochemical hyperthyroidism was observed. Conclusion The use of ATDs in Danish pregnant women increased following the implementation of IF and then leveled out. Results comply with observations in the general Danish population and suggest that IF influences the occurrence of autoimmune hyperthyroidism in younger individuals.

Funder

Novo Nordisk Foundation

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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