Birth defects linked to antithyroid drug treatment in pregnancy

Last revised by Rohit Sharma on 4 Apr 2024

Citation, DOI, disclosures and article data

Citation:

Pfleger R, Sharma R, Bell D, et al. Birth defects linked to antithyroid drug treatment in pregnancy. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-28597

DOI:

https://doi.org/10.53347/rID-28597

Permalink:

https://radiopaedia.org/articles/28597

rID:

28597

Article created:

1 Apr 2014, René Pfleger

Disclosures:

At the time the article was created René Pfleger had no recorded disclosures.

View René Pfleger's current disclosures

Last revised:

4 Apr 2024, Rohit Sharma ◉

Disclosures:

At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.

View Rohit Sharma's current disclosures

Revisions:

7 times, by 5 contributors - see full revision history and disclosures

Systems:

Paediatrics

Tags:

refs, cases, endocrine

Synonyms:

ATD teratogenity
Early pregnancy antithyroid effects
ATD embryopathy
Antithyroid embryopathy

Birth defects linked to antithyroid drug treatment in pregnancy have for a long time been known to exist. Antithyroid drugs, in this context, include methimazole (MMI), carbimazole (CMZ) and propylthiouracil (PTU).

The prevalence of birth defects appears to be high in children exposed to ATD in early pregnancy. Both MMI/CMZ and PTU are associated with an increased odds ratio of birth defects, with an odds ratio approximating 2. The commonest defects in MMI/CMZ-exposed children seem to appear with an adjusted odds ratio ~20 when combined ².

Clinical presentation

MMI/CMZ-exposed children may commonly develop:

choanal atresia
esophageal atresia
omphalocele
omphalomesenteric duct anomalies
aplasia cutis

Both MMI/CMZ and PTU have been shown to be associated with urinary system malformation. Moreover, PTU may predominantly cause malformations in the face and neck region.

Pathology

Hyperthyroidism in pregnant women is a known source of a variety of maternal and fetal complications, necessitating the use of antithyroid drug treatment in pregnancy to control maternal hormone levels.