Women With Chronic Hypoparathyroidism Have Low Risk of Adverse Pregnancy Outcomes

Author:

Björnsdottir Sigridur12ORCID,Clarke Bart3,Mäkitie Outi45,Sandström Anna67,Tiblad Eleonor78,Spelman Tim9,Kämpe Olle21011ORCID

Affiliation:

1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

2. Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden

3. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA

4. Children’s Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

5. Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden

6. Department of Women’s Health, Karolinska University Hospital, Stockholm, Sweden

7. Center of Molecular Medicine, Department of Medicine (Solna), Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

8. Center for Fetal Medicine, Pregnancy Care and Delivery, Women´s Health, Karolinska University Hospital, Huddinge, Sweden

9. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

10. K.G. Jebsen Center for Autoimmune Diseases, University of Bergen, Bergen, Norway

11. Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden

Abstract

Abstract Context There are scarce data on the management of chronic hypoparathyroidism (hypoPT) in pregnant women. Objective The aim of this study was to evaluate pregnancy outcome and total number of births in maternal chronic hypoPT. Methods The Swedish National Patient Register, The Swedish Prescribed Drug Register, Swedish Medical Birth Register, and the Total Population Register were used to identify 97 women with chronic hypoPT and 1030 age-matched controls who delivered 139 and 1577 singleton infants, respectively, following diagnosis between 1997 and 2017. Results Women in the chronic hypoPT group had more frequent diabetes (DM) and chronic kidney disease (CKD) compared with the control group (P = 0.043 and P < 0.001, respectively). After adjusting for DM, CKD, maternal age at delivery, and calendar year of delivery, chronic hypoPT cases were associated with increased risk of induction of labor (OR, 1.82; 95% CI, 1.13-2.94) and birth of infants with lower birth weight (β-coefficient −188 g; 95% CI, −312.2 to −63.8) compared with controls. No difference was found in infant length, small for gestational age, or head circumference after adjustments. Mean gestational age at delivery after controlling for DM, CKD, and pre-eclampsia was not significantly younger (P = 0.119). There was no difference in congenital malformations or perinatal death and no difference in the total number of infants born between groups (P = 0.518). Conclusion The majority of women with chronic hypoPT had normal pregnancy outcomes, and the overall risks appear low. Maternal chronic hypoPT is, however, associated with higher risk of induction of labor and slightly lower infant birth weight.

Funder

Swedish Research Council

Novo Nordisk Foundation

Torsten and Ragnar Söderberg’s Foundations

Kristian Gerhard Jebsen Foundation

Knut and Alice Wallenberg Foundation

Publisher

The Endocrine Society

Subject

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

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