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.
Highlights
Clinical hyperthyroidism which is a common endocrinopathy in pregnancy affects about 0.2%2.7% of all pregnancies in the world [1,2,3,4]
Embase, Pubmed, Web of Knowledge, and BIOSIS Citation Index were searched to find out studies about congenital anomalies in children exposed to Antithyroid drugs (ATDs) in-utero reported up to May 2014
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 I2 tests
Summary
Clinical hyperthyroidism which is a common endocrinopathy in pregnancy affects about 0.2%2.7% of all pregnancies in the world [1,2,3,4]. Antithyroid drugs (ATDs) including propylthiouracil (PTU), methimazole (MMI), and carbimazole (CMZ, prodrug to MMI) are the first line treatment of hyperthyroidism in pregnant women [7,8]. These drugs have equal effects in the treatment of prenatal hyperthroidism. They are known to cross the human placenta [9] and may affect the fetus. Hyperthyroidism affects about 0.2%-2.7% of all pregnancies, and is commonly managed with antithyroid drugs (ATDs). The present meta-analysis was performed to explore the risk of congenital anomalies in children exposed to ATDs in-utero
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