title: Congenital anomalies in children exposed to antithyroid drugs in-utero: a meta-analysis of cohort studies.
abstract: BACKGROUND
  Hyperthyroidism affects about 0.2%-2.7% of all pregnancies, and is commonly managed with antithyroid drugs (ATDs). However, previous studies about the effects of ATDs on congenital anomalies are controversial. Therefore, the present meta-analysis was performed to explore the risk of congenital anomalies in children exposed to ATDs in-utero.
  
  
  METHODS
  Embase, Pubmed, Web of Knowledge, and BIOSIS Citation Index were searched to find out studies about congenital anomalies in children exposed to ATDs in-utero reported up to May 2014. The references cited by the retrieved articles were also searched. The relative risks (RRs) and confidence intervals (CIs) for the individual studies were pooled by fixed effects models, and heterogeneity was analyzed by chi-square and I2 tests.
  
  
  RESULTS
  Eight studies met the inclusion criteria. Exposure to propylthiouracil (PTU), methimazole/carbimazole (MMI/CMZ), and PTU & MMI/CMZ was investigated in 7, 7 and 2 studies, respectively. The pooled RR was 1.20 (95%CI: 1.02-1.42), 1.64 (95%CI: 1.39-1.92), and 1.83 (95%CI: 1.30-2.56) for congenital anomalies after exposure to PTU, MMI/CMZ, and PTU & MMI/CMZ, respectively.
  
  
  CONCLUSIONS
  The meta-analysis suggests that exposure to ATDs in-utero increases the risk of congenital anomalies. The use of ATDs in pregnancy should be limited when possible. Further research is needed to delineate the exact teratogenic risk for particular congenital anomaly.
authors.affiliation: Department of Maternal and Children Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Huixia
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Emergency and Intensive Care Medicine, The second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Jianfei
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Maternal and Children Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Jiayou
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Pharmacy, Xiangya Hospital, Central South University, Changsha Hunan Province, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Zeng
authors.affiliation: Department of Maternal and Children Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Na
authors.initials: N
authors.lastname: Feng
authors.affiliation: Department of Maternal and Children Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhu
authors.affiliation: Department of Maternal and Children Health, School of Public Health, Central South University, Changsha, Hunan Province, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Feng
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000209:etiology*; D013956:Antithyroid Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002231:Carbimazole / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy; D007231:Infant, Newborn; D008713:Methimazole / Q000009:adverse effects / Q000627:therapeutic use; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011441:Propylthiouracil / Q000009:adverse effects / Q000627:therapeutic use; D012306:Risk
chemical_list: D013956:Antithyroid Agents; D008713:Methimazole; D011441:Propylthiouracil; D002231:Carbimazole