| Description | SAFE-Med Study Group Members
Eduardo E. Castilla—CEMIC, Buenos Aires, Argentina; and ECLAMC-FIOCRUZ, Rio de Janeiro, Brazil. Marian K. Bakker—EUROCAT Northern Netherlands, Department of Genetics, University Medical Centre Groningen, University of Groningen, The Netherlands. Sebastiano Bianca—ISMAC Registry, Genetica Medica, ARNAS Garibaldi Nesima, Catania, Italy. Guido Cocchi—IMER, Institute of Neonatology and Preventive Pediatric Health Care, Bologna University, Bologna, Italy. Caterine de Vigan—INSERM, Epidemiological Research Unit on Perinatal and Women’s Health, Villejuif, France. Paul Merlob—Department of Neonatology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel. Anna Pierini—Institute of Clinical Physiology, Unit of Epidemiology, CNR Area di Ricerca di San Cataldo, Pisa, Italy. Gioacchino Scarano—Campania Birth Defects Register, Division of Medical Genetics, General Hospital “G. Rummo” Benevento, Italy; and Regional Epidemiologic Observatory, Health Council, Benevento, Italy. Antonin Sipek—National Registry of Congenital Anomalies in the Czech Republic, Department of Medical Genetics, Thomayer’s University Hospital, Prague, Czech Republic. And Michiko Yamanaka—Kanawaga Children’s Medical Center, Division of Obstetrics and Gynecology, Yokohama City, Japan. | en |
| Abstract | Context: Clinical hyperthyroidism is not uncommon in pregnancy, with a reported prevalence of
0.1 to 0.4%. The available antithyroid drugs are propylthiouracil and methimazole/carbimazole.
Objectives: In this report we examined the association of both drugs with congenital malformations
using data from the International Clearinghouse for Birth Defects Surveillance and Research.
Design: The study used a case-affected control analysis and included 18,131 cases with malformations
and reported first-trimester exposure to medication. A total of 127 subjects were born to
mothers with known first-trimester antithyroid drug exposure.
Results: Among the 52 groups of malformations that were analyzed, situs inversus dextrocardia,
isolated unilateral kidney a/dysgenesis, and cardiac outflow tract defects were associated with
prenatal exposure to propylthiouracil based on three, two, and five cases, respectively. Prenatal
exposure to methimazole/carbimazole was significantly associated with choanal atresia, omphalocele,
and total situs inversus dextrocardia (P 0.01).
Conclusions: Further studies are required to exhaustively evaluate the associations between propylthiouracil
and birth defects because of the low number, the lack of biological plausibility, and
the possibility of underdiagnosis. Association between methimazole/carbimazole exposure and
omphalocele and choanal atresia is consistent with previous reports and definitely suggests that
these malformations could be part of a specific, even if rare, embryopathy. | pt_BR |
