The Treatment of Hypothyroidism Among Pregnant Women: A Retrospective Analysis [13M]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 131 Suppl 1; no. 1; p. 144S
• Main Authors: Lage, Maureen, Espaillat, Ramon, Vora, Jamie, Hepp, Zsolt
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2018
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000533069.20460.e3

INTRODUCTION:This study examined treatment patterns of hypothyroidism among pregnant women. METHODS:The Optum ClinformaticsTM DataMart retrospective claims database was used to identify women in 2014 who were age 18 to 49, were identified as having hypothyroidism, and had at least one recorded thyroid-stimulating hormone (TSH) laboratory value during their pregnancy (N=3,448). The study examines differences in characteristics between pregnant patients treated with levothyroxine (N=2,340) and untreated pregnant patients (N=1,108) as well as treatment target achievement based upon American Thyroid Association guidelines (2011). RESULTS:The average age was 32.76 years old (SD=4.80) with a median TSH value of 1.97 mIU/L (interquartile range 1.27 to 3.53). Compared to untreated pregnant women, treatment with levothyroxine was associated with significantly younger age (32.57 versus 33.14 years; P=0.0011), a lower Charlson Comorbidity Index (0.16 v 0.21; P=0.0086), and lower rates of comorbid type 2 diabetes (4.79% versus 6.77%; P=0.0164) and migraines (2.74% versus 4.06%; P=0.0376). Among women treated with levothyroxine, 52.61% had a last recorded TSH value consistent with ATA guidelines, 23.85% were under-treated, 1.03% were over-treated, and 22.52% did not have TSH monitored during their pregnancy. CONCLUSION:This study found significant differences in general health and comorbidities between pregnant women treated with levothyroxine and those untreated. These results suggest that a relatively large percentage of pregnant women are not being appropriately managed for their hypothyroidism.