University of Oulu

Turunen, S, Vääräsmäki, M, Marttila, R, et al.. Indications for intensive care unit treatment among neonates born to mothers with thyroid disease: a population-based cohort study. Acta Obstet Gynecol Scand. 2022; 101: 1093- 1101. doi: 10.1111/aogs.14413

Indications for intensive care unit treatment among neonates born to mothers with thyroid disease : a population-based cohort study

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Author: Turunen, Suvi1; Vääräsmäki, Marja1; Marttila, Riitta2;
Organizations: 1Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland
2Department of Pediatrics, Oulu University Hospital, Oulu, Finland
3Finnish Institute for Health and Welfare, Department of Knowledge Brokers, Helsinki, Finland
4Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
5Northern Finland Laboratory Center Nordlab, Oulu, Finland
6Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
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Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2022-08-05


Introduction: Thyroid diseases in pregnancy are relatively common and are associated with adverse pregnancy and perinatal outcomes, increasing a neonate’s risk of admission to the neonatal intensive care unit (NICU). The aim of this study was to evaluate the indications for increased risk of NICU admission among the neonates of hypothyroid and hyperthyroid mothers.

Material and methods: The study data consisted of all singleton deliveries (n = 734 773) between 2004 and 2016 in Finland collected from the Finnish Medical Birth Register. The odds of NICU admission (with 95% confidence intervals) were compared between the neonates of hypothyroid or hyperthyroid mothers and of mothers without any thyroid diseases by specified neonatal characteristics and morbidities using logistic regression analysis. The studied neonatal characteristics were preterm birth (<37+0 gestational weeks), low birthweight (<2500 g), the rate of small- and large-for-gestational age infants, and eight disease-specific neonatal outcomes: asphyxia, respiratory distress syndrome, meconium aspiration syndrome, pneumothorax, cardiovascular problems, infections, jaundice and hypoglycemia.

Results: The most common indications for NICU care were principally the same in the neonates of the mothers with and without thyroid disease: respiratory distress syndrome, infections, preterm birth, low birthweight and neonatal hypoglycemia. The preterm neonates, neonates with low birthweight, and large-for-gestational-age infants had increased odds of NICU admission if their mother had hypothyroidism. Also neonates with cardiovascular problems, jaundice or hypoglycemia associated with maternal diabetes had increased odds of NICU admissions if their mother had hypothyroidism. Further, the preterm neonates, large-for-gestational-age infants, and term infants with jaundice had increased odds of NICU admission if their mother had hyperthyroidism.

Conclusions: The most common indications for NICU care were similar for the neonates of the mothers with and without thyroid disease. However, the neonates of the mothers with thyroid diseases were more likely to need NICU care. The neonates of the mothers with thyroid diseases had higher odds of NICU treatment in cases of preterm birth, large for gestational age, and hypoglycemia.

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Series: Acta obstetricia et gynecologica Scandinavica
ISSN: 0001-6349
ISSN-E: 1600-0412
ISSN-L: 0001-6349
Volume: 101
Issue: 10
Pages: 1093 - 1101
DOI: 10.1111/aogs.14413
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This work was supported in part by the Northern Ostrobothnia Hospital District (Dr. Turunen), the Finnish Medical Society Duodecim (Dr. Turunen), the Drugs and Pregnancy project of the Finnish Institute for Health and Welfare (THL), the Finnish Medicines Agency (FIMEA) and the Social Insurance Institution of Finland (Kela) (Prof. Gissler and Dr. Leinonen).
Copyright information: © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.