Article
Endocrinology & Metabolism
Suvi Turunen, Marja Vaarasmaki, Maarit Leinonen, Mika Gissler, Tuija Mannisto, Eila Suvanto
Summary: The study found a significant increase in the use of levothyroxine in pregnant women over recent years, while the use of antithyroid drugs during pregnancy remained very rare.
EUROPEAN THYROID JOURNAL
(2021)
Article
Medicine, General & Internal
Monica Livia Gheorghiu, Roxana Georgiana Bors, Ancuta-Augustina Gheorghisan-Galateanu, Anca Lucia Pop, Dragos Cretoiu, Valentin Nicolae Varlas
Summary: This retrospective study analyzed the treatment of hyperthyroidism in 36 pregnancies of 29 women and found that women with long-term antithyroid drug treatment before pregnancy had better control of thyroid function and fewer pregnancy and fetal complications compared to those diagnosed during pregnancy.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Endocrinology & Metabolism
Xin Hou, Haixia Guan, Shuang Sun, Yang Shi, Chenyan Li, Aihua Liu, Yongze Li, Xiaotong Gao, Yuanyuan Hou, Yang Yang, Yushu Li, Zhongyan Shan, Weiping Teng
Summary: Subnormal TSH levels and TRAb positivity at the time of ATD withdrawal in early pregnancy may be associated with rebound of Graves' hyperthyroidism and increase the risk of adverse pregnancy outcomes.
Review
Endocrinology & Metabolism
Ying Cheng, Xin-Yu Xia, Wei Zhang, Li Ren, Chen-Fu Tian, Dan Liu, Gang Xue
Summary: This study aimed to investigate the clinical characteristics of antithyroid drug-induced aplastic anemia over the past 30 years. A total of 17 cases were analyzed, with a male to female ratio of 1:16. The majority of patients were treated with methimazole (MMI) at doses ≥ 30 mg/day. Aplastic anemia occurred within 6 months of therapy initiation in most cases. Prompt drug cessation and appropriate treatments resulted in favorable prognosis for the majority of patients.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Qingxing Xie, Xinyi Zhang, Jinfang Ma, Xi Lu, Yuwei Zhang, Nanwei Tong
Summary: This study aims to investigate the appropriate iodine nutritional status for patients with Graves' disease hyperthyroidism who are on antithyroid drugs (ATD) or have stopped taking them. The results suggest that adequate iodine intake is associated with a lower recurrence rate, a higher remission rate, and a better efficacy in controlling thyrotoxicosis.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Medicine, General & Internal
Chih-Hsueh Tseng, Chi-Lung Tseng, Harn-Shen Chen, Pei-Lung Chen, Chun-Jui Huang
Summary: Thionamide-induced agranulocytosis (TiA) is a rare adverse event that requires prompt recognition to reduce mortality rate. This study found that patients with TiA tend to have higher levels of free T4 and ANC compared to those with non-TiA neutropenia.
JOURNAL OF THE CHINESE MEDICAL ASSOCIATION
(2023)
Article
Endocrinology & Metabolism
Dongchun Zhu, Shiqi Zhang, Xi Cao, Quan Xia, Qiu Zhang, Datong Deng, Shan Gao, Haixia Yu, Yaru Liu, Haiyun Zhou, Fangbiao Tao, Xuqun Sun
Summary: Agranulocytosis caused by thionamide antithyroid drugs was analyzed in 36 patients with hyperthyroidism. Methimazole led to more severe agranulocytosis compared to propylthiouracil. Patients with severe agranulocytosis required longer recovery times and had closer to normal thyroid hormone levels. Education for patients is crucial in preventing adverse drug reactions.
ENDOCRINE PRACTICE
(2021)
Article
Rheumatology
Julien Culerrier, Yann Nguyen, Omer Karadag, Sule Yasar Bilge, Tuba Demirci Yildrim, Tahir Saygin Ogut, Veli Yazisiz, Cemal Bes, Ayse Celfe, Ayten Yazici, Oznur Sadioglu Cagdas, Andreas Kronbichler, David Jayne, Philipp Gauckler, Alexis Regent, Vitor Teixeira, Sylvain Marchand-Adam, Pierre Duffau, Saskia Ingen- Housz-Oro, Celine Droumaguet, Baptiste Andre, Luminita Luca, Sarah Lechtman, Achille Aouba, Celine Lebas, Amelie Servettaz, Amandine Dernoncourt, Marc Ruivard, Anne-Marie Milesi, Vincent Poindron, Patrick Jego, Roberto Padoan, Paolo Delvino, Frederic Vandergheynst, Christian Pagnoux, Elaine Yacyshyn, Peter Lamprecht, Oliver Flossmann, Xavier Puechal, Benjamin Terrier
Summary: This retrospective multicentre study aimed to investigate the characteristics and outcome of ANCA-associated vasculitis (AAV) induced by anti-thyroid drugs (ATD) compared to primary AAV. The results showed that ATD-induced AAV mainly presented as microscopic polyangiitis (MPA), with the most common manifestations being skin involvement, arthralgia, and glomerulonephritis. However, ATD-induced MPA was less severe and had a lower risk of relapse compared to primary MPA.
Article
Medicine, General & Internal
Natalie R. Daya, Anna Fretz, Seth S. Martin, Pamela L. Lutsey, Justin B. Echouffo-Tcheugui, Elizabeth Selvin, Stephen P. Juraschek
Summary: This study investigated the association of endogenous subclinical thyroid dysfunction and fracture risk, independent of clinical confounders.
Review
Endocrinology & Metabolism
Stine Linding Andersen, Stig Andersen
Summary: Managing hyperthyroidism in pregnant women, especially those with Graves' disease, is crucial to prevent complications. The consequences of maternal hyperthyroidism on fetal growth and development are less understood compared to hypothyroidism. While experimental studies suggest potential adverse effects, human studies on developmental outcomes in children born to mothers with hyperthyroidism are inconclusive. More research is needed to understand the impact of hyperthyroidism and its treatment on pregnancy outcomes.
ENDOCRINE CONNECTIONS
(2021)
Article
Endocrinology & Metabolism
Claudia Ashkar, Shoshana Sztal-Mazer, Duncan J. Topliss
Summary: The management of Graves' disease in women of childbearing potential is complex, involving multiple stages and considerations for both the mother and the fetus. This includes managing hyperthyroidism, considering antithyroid drug therapy, iodine supplementation, and monitoring TSH receptor antibodies. Radioiodine is contraindicated during pregnancy and breastfeeding, and thyroid function testing is recommended in remission to detect recurrence of Graves' disease.
CLINICAL ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Natsuko Watanabe, Jaeduk Yoshimura Noh, Takashi Akamizu, Masanobu Yamada
Summary: This study investigated the actual administration of thiamazole in clinical practice, and found that a daily dose of 15 mg was the most common initial therapy for most patients. Thiamazole was also administered to lactating mothers following the treatment guidelines.
Review
Biochemistry & Molecular Biology
Charles Megier, Gregoire Dumery, Dominique Luton
Summary: Thyroid hormones and iodine are crucial for regulating various physiological functions, such as metabolic rate, protein synthesis, and fetal development. Imbalances in thyroid and iodine metabolism can have negative effects, especially during pregnancy. The placenta, as the interface between the mother and fetus, plays a vital role in regulating thyroid and iodine metabolism. This review provides an update on the current understanding of thyroid and iodine metabolism in both normal and pathological pregnancies, highlighting their importance for maternal and fetal health.
Article
Endocrinology & Metabolism
Ari Song, Su Jin Kim, Min-Sun Kim, Jiyeon Kim, Insung Kim, Ga Young Bae, Eunseop Seo, Young Seok Cho, Joon Young Choi, Sung Yoon Cho, Dong-Kyu Jin
Summary: This retrospective study of 195 children and adolescents with Graves' disease in Korea found that the cumulative remission rate increased with the duration of antithyroid drug (ATD) treatment. FT4 level at diagnosis was identified as a predicting factor for remission, and long-term methimazole treatment was shown to be a useful option before definitive treatment in children and adolescents with GD.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Review
Endocrinology & Metabolism
Medha Agrawal, Steffan Lewis, Lakdasa Premawardhana, Colin M. Dayan, Peter N. Taylor, Onyebuchi E. Okosieme
Summary: The risk of congenital anomalies with ATD therapy in pregnancy is higher for CMZ/MMI than for PTU, and switching ATDs during pregnancy does not reduce this risk. The untreated group's risk does not differ from control or ATD groups but is highly heterogeneous in terms of thyroid status.
CLINICAL ENDOCRINOLOGY
(2022)
Article
Biochemistry & Molecular Biology
Justiina Ronkainen, Anni Heiskala, Florianne O. L. Vehmeijer, Estelle Lowry, Doretta Caramaschi, Guadalupe Estrada Gutierrez, Jonathan A. Heiss, Nadine Hummel, Elina Keikkala, Tuomas Kvist, Allison Kupsco, Phillip E. Melton, Giancarlo Pesce, Munawar H. Soomro, Marta Vives-Usano, Nour Baiz, Elisabeth Binder, Darina Czamara, Monica Guxens, Sanna Mustaniemi, Stephanie J. London, Sebastian Rauschert, Marja Vaarasmaki, Martine Vrijheid, Anette-G. Ziegler, Isabella Annesi-Maesano, Mariona Bustamante, Rae-Chi Huang, Sandra Hummel, Allan C. Just, Eero Kajantie, Jari Lahti, Deborah Lawlor, Katri Raikkonen, Marjo-Riitta Jarvelin, Janine F. Felix, Sylvain Sebert
Summary: This study did not find evidence for an association between maternal hemoglobin levels during pregnancy and offspring DNA methylation. However, it does not rule out the possibility that such associations could be seen in studies with more extreme maternal hemoglobin levels. Most participants had maternal hemoglobin levels within the normal range, while adverse perinatal outcomes typically arise in extreme cases.
Article
Pharmacology & Pharmacy
Nicolas H. Thurin, Romin Pajouheshnia, Giuseppe Roberto, Caitlin Dodd, Giulia Hyeraci, Claudia Bartolini, Olga Paoletti, Hedvig Nordeng, Helle Wallach-Kildemoes, Vera Ehrenstein, Elena Dudukina, Thomas MacDonald, Giorgia De Paoli, Maria Loane, Christine Damase-Michel, Anna-Belle Beau, Cecile Droz-Perroteau, Regis Lassalle, Jorieke Bergman, Karin Swart, Tania Schink, Clara Cavero-Carbonell, Laia Barrachina-Bonet, Ainhoa Gomez-Lumbreras, Maria Giner-Soriano, Maria Aragon, Amanda J. Neville, Aurora Puccini, Anna Pierini, Valentina Ientile, Gianluca Trifiro, Anke Rissmann, Maarit K. Leinonen, Visa Martikainen, Sue Jordan, Daniel Thayer, Ieuan Scanlon, Mary E. Georgiou, Marianne Cunnington, Morris Swertz, Miriam Sturkenboom, Rosa Gini
Summary: The ConcePTION project aims to reduce uncertainty about the safety of medication use in pregnancy and breastfeeding by building an ecosystem and leveraging a common data model. The model enables European data sources to contribute to major projects and facilitate effective deployment of distributed analytics.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2022)
Article
Public, Environmental & Occupational Health
Sarah Hjorth, Anton Pottegard, Anne Broe, Caroline H. Hemmingsen, Maarit K. Leinonen, Marie Hargreave, Ulrika Norby, Hedvig Nordeng
Summary: This multinational study investigated the association between prenatal nitrofurantoin exposure and childhood leukaemia, and found that there was no substantial association, although a slightly elevated incidence rate ratio (IRR) with confidence intervals including the null was observed. The lack of a dose-response relationship and a clear biological mechanism suggests against a causal association.
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
(2022)
Article
Endocrinology & Metabolism
Kerstin M. G. Brand, Laura Saarelainen, Jaak Sonajalg, Emmanuelle Boutmy, Caroline Foch, Marja Vaarasmaki, Laure Morin-Papunen, Judith Schlachter, Katja M. Hakkarainen, Pasi Korhonen
Summary: The study found that maternal exposure to metformin during pregnancy did not increase the risk of long-term adverse outcomes in offspring compared to insulin. However, metformin and combination treatment were associated with increased risks of adverse outcomes at birth, indicating the need for caution in pregnancies with potential fetal undernutrition risks.
BMJ OPEN DIABETES RESEARCH & CARE
(2022)
Article
Psychiatry
Oskar Halfdanarson, Jacqueline M. Cohen, Oystein Karlstad, Carolyn E. Cesta, Marte-Helene Bjork, Siri Eldevik Haberg, Kristjana Einarsdottir, Kari Furu, Mika Gissler, Vidar Hjellvik, Helle Kieler, Maarit K. Leinonen, Mette Norgaard, Buket Ozturk Essen, Sinna Pilgaard Ulrichsen, Johan Reutfors, Helga Zoega
Summary: The study found that there is little to no increased risk of children developing ADHD or ASD after in utero exposure to antipsychotics, offering reassurance for women who need to use antipsychotics during pregnancy.
EVIDENCE-BASED MENTAL HEALTH
(2022)
Article
Obstetrics & Gynecology
Mikael Huhtala, Hilkka Nikkinen, Elisa Paavilainen, Harri Niinikoski, Marja Vaarasmaki, Britt-Marie Loo, Tapani Ronnemaa, Kristiina Tertti
Summary: This study compared the long-term effects of metformin and insulin treatments on women with gestational diabetes. The results showed that there were no significant differences in the incidences of pre-diabetes, type 2 diabetes, metabolic syndrome, anthropometry, glucose metabolism, serum lipids, or inflammatory markers between the metformin and insulin groups during the treatment period and 9-year follow-up.
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
(2022)
Article
Obstetrics & Gynecology
Aliisa Laitala, Timo Saarela, Marja Vaarasmaki, Mikko Hallman, Outi Aikio
Summary: The use of paracetamol in pregnancy does not have adverse effects on extremely or very preterm infants and may have acute benefits for preterm infants during perinatal transition.
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
(2022)
Article
Obstetrics & Gynecology
Suvi Turunen, Marja Vaarasmaki, Riitta Marttila, Maarit K. Leinonen, Mika Gissler, Tuija Mannisto, Eila Suvanto
Summary: Thyroid diseases in mothers may increase the risk of NICU admission for newborns, especially in cases of preterm birth, low birthweight, and neonatal hypoglycemia.
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
(2022)
Article
Environmental Sciences
Jenni Pukkila, Sanna Mustaniemi, Shilpa Lingaiah, Olli-Pekka Lappalainen, Eero Kajantie, Anneli Pouta, Risto Kaaja, Johan G. Eriksson, Hannele Laivuori, Mika Gissler, Marja Vaarasmaki, Elina Keikkala
Summary: Gestational diabetes mellitus (GDM) is associated with increased oral health care needs and symptoms, especially third molar symptoms, during pregnancy.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Clinical Neurology
Jacqueline M. Cohen, Silje Alvestad, Carolyn E. Cesta, Marte-Helene Bjork, Maarit K. Leinonen, Mette Norgaard, Kristjana Einarsdottir, Anders Engeland, Mika Gissler, Oystein Karlstad, Kari Klungsoyr, Ingvild Odsbu, Johan Reutfors, Randi M. Selmer, Torbjoern Tomson, Sinna Pilgaard Ulrichsen, Helga Zoega, Kari Furu
Summary: This study compares the safety of different antiseizure medications in monotherapy during pregnancy regarding the risk of major congenital malformations (MCMs). The study found that lamotrigine monotherapy does not significantly increase the risk of MCMs compared to pregnancies without antiseizure medication exposure. However, valproate and topiramate are associated with an increased risk of MCMs, while carbamazepine, oxcarbazepine, and levetiracetam do not pose an increased risk.
ANNALS OF NEUROLOGY
(2023)
Article
Psychiatry
Krista F. Huybrechts, Loreen Straub, Par Karlsson, Laura Pazzagli, Kari Furu, Mika Gissler, Sonia Hernandez-Diaz, Mette Norgaard, Helga Zoega, Brian T. Bateman, Carolyn E. Cesta, Jacqueline M. Cohen, Maarit K. Leinonen, Johan Reutfors, Randi M. Selmer, Elizabeth A. Suarez, Sinna Pilgaard Ulrichsen, Helle Kieler
Summary: In this study, in utero antipsychotic exposure was generally not significantly associated with an increased risk of malformations, although increased risks were observed for specific combinations. The association between olanzapine and oral clefts, gastroschisis and other specific brain anomalies with atypical antipsychotics, and cardiac malformations with chlorprothixene should be further investigated.
Article
Endocrinology & Metabolism
Lars J. Kjerpeseth, Carolyn E. Cesta, Kari Furu, Anders Engeland, Mika Gissler, Hanne L. Gulseth, Oystein Karlstad, Maarit K. Leinonen, Laura Pazzagli, Helga Zoega, Jacqueline M. Cohen
Summary: This study aimed to assess the risk of major congenital malformations with metformin versus insulin in pregnancies with type 2 diabetes. The results showed no increased risk of congenital malformations with the use of metformin compared to insulin.
Article
Orthopedics
Arimatias Raitio, Susanna Heiskanen, Johanna Syvanen, Maarit K. K. Leinonen, Teemu Kemppainen, Eliisa Loyttyniemi, Matti Ahonen, Mika Gissler, Ilkka Helenius
Summary: The etiology and maternal risk factors for congenital vertebral defects are not clear. This nationwide register-based case-control study found that maternal pregestational diabetes and rheumatoid arthritis were significant risk factors. Additionally, estrogens and heparins, commonly used in assisted reproductive technologies, were associated with an increased risk. A sensitivity analysis also suggested a link between maternal smoking and an elevated risk of vertebral anomalies.
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
(2023)
Article
Clinical Neurology
Julie Werenberg Dreier, Marte-Helene Bjork, Silje Alvestad, Mika Gissler, Jannicke Igland, Maarit K. Leinonen, Yuelian Sun, Helga Zoega, Jacqueline M. Cohen, Kari Furu, Torbjorn Tomson, Jakob Christensen
Summary: This study found an association between prenatal exposure to antiseizure medication and a spectrum of psychiatric disorders in childhood and adolescence. The results showed that prenatal exposure to valproate was associated with neurodevelopmental disorders, while prenatal exposure to lamotrigine, carbamazepine, and oxcarbazepine was not associated with an increased risk of psychiatric disorders.
Editorial Material
Clinical Neurology
Marte-Helene Bjork, Torbjoern Tomson, Julie Werenberg Dreier, Silje Alvestad, Nils Erik Gilhus, Mika Gissler, Jannicke Igland, Maarit K. Leinonen, Yuelian Sun, Hakon Magne Vegrim, Helga Zoega, Jakob Christensen
Summary: Women taking antiseizure medication during pregnancy are often advised to take high doses of folic acid supplements (1mg to 5mg) to minimize the risk of birth defects. However, a recent report has shown a link between high dose folic acid intake and an increased risk of childhood cancer in the offspring. This has sparked a debate regarding the recommended dose of folic acid for pregnant women on antiseizure medication. In this Commentary, the authors explain their findings, the methodology used, and address emerging questions.