title: Postpartum thyroiditis in women with hypothyroidism antedating pregnancy?
abstract: In women with hypothyroidism, levothyroxine (LT) requirements after delivery are assumed to return to prepregnancy values. The occasional observation of discordances prompted this study. Forty-one women (31 receiving LT replacement therapy and 10 receiving suppressive therapy for thyroid carcinoma) were followed during the first year after delivery. A control group of 31 nonpregnant women with hypothyroidism (n = 21) or thyroid carcinoma (n = 10) were also followed during a similar period. Twenty-three patients of 41 (56.1%) had discordant requirements at follow-up after delivery vs. 3 of 31 in the control group (9.7%; P < 0.001). The patterns of discordance in the postdelivery group were hyperthyroidism in 12, increase in LT dose in 5, hyper- and hypothyroidism in 5, and recurrence of Graves' disease in 1 women. Those in the control group were increase in LT dose, hyperthyroidism, and hypo- and hyperthyroidism. The rate of patients with discordant prepregnancy-postpartum LT doses was higher in the noncarcinoma subgroup (67.7% vs. 20.0%; P < 0.01), whereas in the control group, both subgroups displayed a similar rate of discordance (9.5% vs. 10%; P = NS). In conclusion, this study documents that women with hypothyroidism antedating pregnancy display changes in LT requirements in the first year after delivery that suggest postpartum thyroiditis.
authors.affiliation: Servei d'Endocrinologia i Nutrició, Hospital de Sant Pau, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Caixàs
authors.forename: M
authors.initials: M
authors.lastname: Albareda
authors.forename: A
authors.initials: A
authors.lastname: García-Patterson
authors.forename: J
authors.initials: J
authors.lastname: Rodríguez-Espinosa
authors.forename: A
authors.initials: A
authors.lastname: de Leiva
authors.forename: R
authors.initials: R
authors.lastname: Corcoy
mesh_terms: D001327:Autoimmune Diseases / Q000188:drug therapy; D005260:Female; D006111:Graves Disease / Q000188:drug therapy; D006801:Humans; D007037:Hypothyroidism / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D016015:Logistic Models; D011247:Pregnancy; D011248:Pregnancy Complications; D011644:Puerperal Disorders / Q000150:complications*; D013964:Thyroid Neoplasms / Q000188:drug therapy; D013966:Thyroiditis / Q000097:blood / Q000150:complications*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use
chemical_list: D013972:Thyrotropin; D013974:Thyroxine