Stine Linding Andersen1, Jørn Olsen, Allan Carlé, Peter Laurberg. 1. Departments of Endocrinology (S.L.A., A.C., P.L.) and Clinical Biochemistry (S.L.A.), Aalborg University Hospital, 9000 Aalborg, Denmark; Department of Clinical Medicine (S.L.A., P.L.), Aalborg University, 9000 Aalborg, Denmark; Section for Epidemiology, Department of Public Health (J.O.), Aarhus University, 8000 Aarhus, Denmark; and Department of Internal Medicine (A.C.), Silkeborg Hospital, 8600 Silkeborg, Denmark.
Abstract
CONTEXT: Hyperthyroidism in women of reproductive age is predominantly caused by Graves' disease. Pregnancy associated changes in the immune system may influence the onset of disease, but population-based incidence rates in and around pregnancy have not been reported. OBJECTIVE: The objective of the study was to estimate the incidence of maternal hyperthyroidism (defined by redeemed prescription of antithyroid drugs) in and around pregnancy and to compare this with the incidence of other autoimmune diseases such as rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). DESIGN: This was a population-based cohort study. SETTING: The study used the Danish nationwide registers. PARTICIPANTS: The participants were women who gave birth to singleton liveborn children in Denmark from 1999 to 2008 (n = 403,958). MAIN OUTCOME MEASURE(S): Incidence rates (IR) of maternal hyperthyroidism during a 4-year period beginning 2 years before and ending 2 years after the date when the mother was giving birth for the first time in the study period were measured. RESULTS: Altogether 3673 women (0.9%) were identified with an onset of hyperthyroidism from 1997 to 2010, and the overall IR of maternal hyperthyroidism was 65.0/100,000/year. The IR of hyperthyroidism in and around pregnancy varied widely and was high in the first 3 months of pregnancy [incidence rate ratio (IRR) vs the remaining study period: 1.50 (95% CI 1.09-2.06)), very low in the last 3 months of pregnancy (0.26 (0.15-0.44)], and reached the highest level 7-9 months postpartum [3.80 (2.88-5.02)]. The incidence variation in and around pregnancy was different for RA and IBD. CONCLUSION: These are the first population-based data on the incidence of hyperthyroidism in and around pregnancy. The incidence of hyperthyroidism was high in early pregnancy and postpartum, whereas such particular pattern was not observed for other diseases of autoimmune origin.
CONTEXT: Hyperthyroidism in women of reproductive age is predominantly caused by Graves' disease. Pregnancy associated changes in the immune system may influence the onset of disease, but population-based incidence rates in and around pregnancy have not been reported. OBJECTIVE: The objective of the study was to estimate the incidence of maternal hyperthyroidism (defined by redeemed prescription of antithyroid drugs) in and around pregnancy and to compare this with the incidence of other autoimmune diseases such as rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). DESIGN: This was a population-based cohort study. SETTING: The study used the Danish nationwide registers. PARTICIPANTS: The participants were women who gave birth to singleton liveborn children in Denmark from 1999 to 2008 (n = 403,958). MAIN OUTCOME MEASURE(S): Incidence rates (IR) of maternal hyperthyroidism during a 4-year period beginning 2 years before and ending 2 years after the date when the mother was giving birth for the first time in the study period were measured. RESULTS: Altogether 3673 women (0.9%) were identified with an onset of hyperthyroidism from 1997 to 2010, and the overall IR of maternal hyperthyroidism was 65.0/100,000/year. The IR of hyperthyroidism in and around pregnancy varied widely and was high in the first 3 months of pregnancy [incidence rate ratio (IRR) vs the remaining study period: 1.50 (95% CI 1.09-2.06)), very low in the last 3 months of pregnancy (0.26 (0.15-0.44)], and reached the highest level 7-9 months postpartum [3.80 (2.88-5.02)]. The incidence variation in and around pregnancy was different for RA and IBD. CONCLUSION: These are the first population-based data on the incidence of hyperthyroidism in and around pregnancy. The incidence of hyperthyroidism was high in early pregnancy and postpartum, whereas such particular pattern was not observed for other diseases of autoimmune origin.
Authors: Marion I Boldingh; Angelina H Maniaol; Cathrine Brunborg; Harald Weedon-Fekjær; Jan J G M Verschuuren; Chantal M E Tallaksen Journal: Neurology Date: 2016-10-21 Impact factor: 9.910
Authors: Peter N Taylor; Diana Albrecht; Anna Scholz; Gala Gutierrez-Buey; John H Lazarus; Colin M Dayan; Onyebuchi E Okosieme Journal: Nat Rev Endocrinol Date: 2018-03-23 Impact factor: 43.330