{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:24:51Z","timestamp":1783488291769,"version":"3.55.0"},"reference-count":43,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T00:00:00Z","timestamp":1433116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Increasing attention has focused on the prevalence and outcomes of hyperthyroidism in pregnancy, given concerns for hepatotoxicity and embryopathy associated with antithyroid drugs (ATDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In an integrated health care delivery system, we examined the prevalence of thyrotoxicosis and gestational ATD use (propylthiouracil [PTU] or methimazole [MMI]) in women with delivered pregnancies from 1996 to 2010. Birth outcomes were compared among all infants and those born to mothers with diagnosed thyrotoxicosis or ATD therapy during gestation, with examination of ATD-associated hepatotoxicity and congenital malformations in the latter subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 453,586 mother\u2013infant pairs (maternal age 29.7\u00b16.0 years, 57.1% nonwhite), 3.77 per 1000 women had diagnosed thyrotoxicosis and 1.29 per 1000 had gestational ATD exposure (86.5% PTU, 5.1% MMI, 8.4% both). Maternal PTU-associated hepatotoxicity occurred with a frequency of 1.80 per 1000 pregnancies. Infants of mothers with diagnosed thyrotoxicosis (odds ratio [OR] 1.28, 95% confidence interval [CI 1.05\u20131.55]) or gestational ATD use (OR 1.31 [1.00\u20131.72]) had an increased risk of preterm birth compared to those born to mothers without thyrotoxicosis or ATD. The risk of neonatal intensive care unit (NICU) admission was also higher with maternal thyrotoxicosis (OR 1.30 [1.07\u20131.59]) and ATD exposure (OR 1.64 [CI 1.26\u20132.13]), adjusting for prematurity. Congenital malformation rates were low and similar among infants born to mothers with thyrotoxicosis or ATD exposure (30\u201344 per 1000 infants).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Gestational ATD exposure occurred in 1.29 per 1000 mother\u2013infant pairs while a much larger number had maternal diagnosed thyrotoxicosis but no drug exposure during pregnancy. Infants of mothers with gestational ATD use or diagnosed thyrotoxicosis were more likely to be preterm and admitted to the NICU. The rates of congenital malformation were low for mothers diagnosed with thyrotoxicosis and did not differ by ATD use. Among women with gestational PTU therapy, the frequency of PTU-associated hepatotoxicity was 1.8 per 1000 delivered pregnancies. These findings from a large, population-based cohort provide generalizable estimates of maternal and infant risks associated with maternal thyrotoxicosis and related pharmacotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2014.0434","type":"journal-article","created":{"date-parts":[[2015,3,6]],"date-time":"2015-03-06T13:32:50Z","timestamp":1425648770000},"page":"698-705","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["Gestational Thyrotoxicosis, Antithyroid Drug Use and Neonatal Outcomes Within an Integrated Healthcare Delivery System"],"prefix":"10.1177","volume":"25","author":[{"given":"Joan C.","family":"Lo","sequence":"first","affiliation":[{"name":"Division of Research"},{"name":"Kaiser Permanente Oakland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Rivkees","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malini","family":"Chandra","sequence":"additional","affiliation":[{"name":"Division of Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel R.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Division of Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Korelitz","sequence":"additional","affiliation":[{"name":"Department of Health Studies, Westat, Rockville, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Kuzniewicz","sequence":"additional","affiliation":[{"name":"Division of Research"},{"name":"Kaiser Permanente Oakland Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,6,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/edrv-14-2-194"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2008.1234"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2011.07.010"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0087"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0488"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1998.8.859"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.0079"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmh008"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1993.tb00512.x"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1999.9.653"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(03)00173-6"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0141"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.32497"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19990305)83:1<43::AID-AJMG8>3.0.CO;2-C"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/tera.1072"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1159\/000329186"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc0809750"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1687-9856-2009-132041"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-5-461"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03349663"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/1687-9856-2010-658267"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP.17.3.456"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra042972"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2803"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0877"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/00019514-199705040-00003"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.4.822"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-3-13"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1602667"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.285606"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90088-4"},{"key":"e_1_3_3_33_2","first-page":"946","article-title":"Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism","volume":"84","author":"Millar LK","year":"1994","unstructured":"Millar LK, , Wing DA, , Leung AS, , Koonings PP, , Montoro MN, , Mestman JH. 1994. 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