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Am J Perinatol 2017; 34(14): 1447-1450
DOI: 10.1055/s-0037-1604289
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effect of Treated Overt Hypothyroidism on Outcomes in Twin Pregnancies

Jonathan Y. Rosner
1   Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
,
Nathan S. Fox
2   Carnegie Imaging for Women, PLLC, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Maternal Fetal Medicine Associates, PLLC New York, New York
,
Daniel Saltzman
2   Carnegie Imaging for Women, PLLC, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Maternal Fetal Medicine Associates, PLLC New York, New York
,
Andrei Rebarber
2   Carnegie Imaging for Women, PLLC, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Maternal Fetal Medicine Associates, PLLC New York, New York
,
Simi Gupta
2   Carnegie Imaging for Women, PLLC, Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, Maternal Fetal Medicine Associates, PLLC New York, New York
› Author Affiliations
Further Information

Publication History

09 April 2017

13 June 2017

Publication Date:
13 July 2017 (online)

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Abstract

Objective The objective of this study was to determine if treatment of overt hypothyroidism in twin pregnancies reduces adverse outcomes associated with overt hypothyroidism in pregnancy.

Methods This is a retrospective cohort study of all patients who were presented with twin gestations between 2005 and 2013 to a single obstetrical practice. Patients who were diagnosed with overt hypothyroidism were identified. Patients were followed up with serial thyroid function tests and treated appropriately. Rates of adverse pregnancy outcomes were compared between patients with and without hypothyroidism with p < 0.05 used for significance.

Results In this study, 612 twin pregnancies were included; 85 patients were diagnosed with overt hypothyroidism. Patients with overt hypothyroidism were more likely to have had in vitro fertilization (78 vs. 62%; p < 0.01). After adjusting for confounding variables, patients with overt hypothyroidism had no increased risk of spontaneous preterm birth < 37 weeks' gestation (adjusted odds ratio [aOR]: 0.833; 95% confidence interval [CI]: 0.498–1.393), intrauterine growth restriction (aOR: 0.720; 95% CI: 0.446–1.163), gestational diabetes (aOR: 0.812; 95% CI: 0.353–1.871), or composite adverse outcomes (aOR: 0.659; 95% CI 0.391–1.111) compared with patients who did not have overt hypothyroidism. There was a trend toward decreased hypertensive disorders of pregnancy (aOR: 0.470; 95% CI: 0.234–0.944).

Conclusion Our study shows that in twin gestations, there is no increased risk of adverse pregnancy outcomes between patients with treated overt hypothyroidism and those without overt hypothyroidism.

Keywords

twins - hypothyroidism - adverse outcomes - levothyroxine

Note

The study was presented at the Society for Reproductive Investigation 62nd Annual Scientific Meeting, San Francisco, CA, March 25–28, 2015.


 

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