A recent study investigated the experiences of patients with chronic hypoparathyroidism in pregnancy.
The study ultimately found that these patients typically had low risk pregnancies and normal outcomes. However, they did have higher rates of inductions.
Chronic Hypoparathyroidism in Pregnancy
Chronic hypoparathyroidism is most common in women.
When women with the condition are pregnant, close monitoring is incredibly important. This is because hypercalcemia and hypocalcemia can influence the developing fetus. Unfortunately, research on how to manage this condition while pregnant is not well developed.
This study improved our understanding of managing hypoparathyroidism in pregnancy through the use of patient registers. This study, conducted in Sweden, examined how this condition can influence outcomes in pregnancy with 1,520 patients. Additionally examined were 15,200 individuals who served as a control group. The data was from 1997 to 2017.
- 6.4% of all patients gave birth (totaling 139 births)
- 6.8% of individuals in the control group gave birth (1,577 births)
- The average age of diagnosis was 26.9 years
- 76.4% of patients had post surgical chronic hypoparathyroidism
- 23.6% of patients had nonsurgical chronic hypoparathyroidism
Between both groups, average weight, smoking status, age at the time of delivery, year they delivered, and whether or not they were working were similar. More patients received thyroxine than those in the control group.
Results
Here are some of the notable results from this evaluation.
- Patients had a 1.82 fold higher risk of having their labor induced (after adjustments for maternal age, chronic kidney disease, calendar year, and diabetes)
- Independent of gestational age and preeclampsia, patients still had a 1.79 fold higher risk of induction
- When thyroxine use was controlled, the risk of induction was no longer significant.
- No differences between groups for postpartum hemorrhage or c-section delivery were noted
- Average newborn weight was lower for patients (even after chronic kidney disease, diabetes, calendar year, and maternal age were adjusted and gestational weight, thyroxine exposure, and preeclampsia were controlled)
- There were no differences in regard to being small for the child’s gestational age, baby’s length, or baby’s head circumference
- There were no significant differences between the surgical group and the nonsurgical group
Although more research is needed, including long-term assessment and genetic analyses, this study provides a great starting point for our greater understanding of chronic hypoparathyroidism in pregnancy. It demonstrated that pregnancy outcomes tend to be normal for this patient population but induction is more common.
The researchers concluded that pregnant patients should be monitored throughout the duration of their pregnancy despite these promising outcomes.
Reference
Björnsdottir S, Clarke B, Mäkitie O, et al. Women with chronic hypoparathyroidism have low risk of adverse pregnancy outcomes. J Clin Endocrinol Metab. Published online July 8, 2021. doi:10.1210/clinem/dgab503
You can read more about this study here.
