Fetal and Maternal Outcomes of Gestational Thyrotoxicosis: Single Center Experience, Retrospective Cohort

Abstract

Objective: Gestational thyrotoxicosis may lead to adverse maternal and fetal events. In this study, the aim was to compare the gestational thyrotoxicosis cases with the control group in terms of their differential diagnoses, clinical observation and gestational follow-up outcomes. Materials and Methods: Pregnant patients with subclinical or overt thyrotoxicosis who were followed up in endocrinology outpatient clinic between December 2009-September 2019 were included in the study. Patients were grouped according to the diagnosis of gestational transient thyrotoxicosis (GTT), Graves’ disease, toxic nodular goiter (TNG), and intra-group comparisons and comparisons with the control group were made in terms of the presence of maternal and fetal pregnancy complications during the gestational period, delivery week, and infant birthweight. Results: A total of 115 patients were divided into GTT group, which had 50 patients, Graves’ group, which had 14 patients, TNG group, which had 1 patient, and control group, which had 50 patients. The prevalence of hyperemesis gravidarum was the highest in GTT group, with 40%. Eclampsia was found in 2 (14.2%) of the pregnant women with Graves’ disease and was not found in other groups (p=0.01). Neonatal death was found in 3 (21.4%) of the pregnant women with Graves’ disease, and 1 (2%) of the pregnant women with GTT (p=0.01). There was a significant positive correlation between delivery week and TSH (p=0.001, r:0.64), and a significant negative correlation withft3(p=0.04 r:-0.3). A significant positive correlation was detected between infant birthweight and TSH and delivery week (p=0.03 r:0.32 and p<0.001 r:0.41, respectively). Conclusion: Gestational transient thyrotoxicosis does not affect infant birthweight and perinatal complications, whereas the prevalence of low infant birthweight and maternal eclampsia is higher in Graves’ disease.