View : 80 Download: 0

Association Between Pregnancy Outcomes and Radioactive Iodine Treatment After Thyroidectomy Among Women With Thyroid Cancer

Title
Association Between Pregnancy Outcomes and Radioactive Iodine Treatment After Thyroidectomy Among Women With Thyroid Cancer
Authors
Kim, Hye OkLee, KyungjongLee, Sang MooSeo, Gi Hyeon
Ewha Authors
김혜옥
Issue Date
2020
Journal Title
JAMA INTERNAL MEDICINE
ISSN
2168-6106JCR Link

2168-6114JCR Link
Citation
JAMA INTERNAL MEDICINE vol. 180, no. 1, pp. 54 - 61
Publisher
AMER MEDICAL ASSOC
Indexed
SCI; SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Importance Current guidelines recommend that women delay pregnancy for 6 to 12 months after the receipt of radioactive iodine treatment (RAIT) following thyroidectomy for differentiated thyroid carcinoma. Although concerns exist regarding the risks associated with pregnancy after RAIT, no large-scale study, to date, has investigated the association between RAIT and pregnancy outcomes. Objective To investigate whether RAIT was associated with increases in adverse pregnancy outcomes among South Korean women who received RAIT after thyroidectomy for thyroid cancer and to evaluate the appropriate interval between RAIT and conception. Design, Setting, and Participants This population-based cohort study used the Health Insurance Review and Assessment database of South Korea to identify a total of 111 & x202f;459 women of childbearing age (20-49 years) who underwent thyroidectomy for the treatment of differentiated thyroid carcinoma between January 1, 2008, and December 31, 2015. Participants were allocated to 2 cohorts: those who underwent surgery alone (n = 59 & x202f;483 [53.4%]) and those who underwent surgery followed by RAIT (n = 51 & x202f;976 [46.6%]). The pregnancy outcomes data were collected from January 1, 2008, to December 31, 2017. Main Outcomes and Measures The rates of abortion (both spontaneous and induced), preterm delivery, and congenital malformation were assessed. Multivariate logistic regression models were used to control for confounding variables. Results Among the 111 & x202f;459 women of childbearing age who underwent thyroidectomy with or without RAIT for the treatment of thyroid cancer, the mean (SD) age at surgery or RAIT was 39.8 (6.7) years. Of those, 10 & x202f;842 women (9.7%) became pregnant, and the mean (SD) age at conception was 33.3 (4.4) years. The rates of abortion, preterm delivery, and congenital malformation among patients who underwent surgery alone compared with patients who underwent surgery followed by RAIT were 30.7% vs 32.1% for abortion, 12.8% vs 12.9% for preterm delivery, and 8.9% vs 9.0% for congenital malformation, respectively (P > .05). A subgroup analysis based on the interval between RAIT and conception indicated congenital malformation rates of 13.3% for the interval of 0 to 5 months, 7.9% for 6 to 11 months, 8.3% for 12 to 23 months, and 9.6% for 24 months or more. The adjusted odds ratio of congenital malformation was 1.74 (95% CI, 1.01-2.97; P = .04) in conceptions that occurred 0 to 5 months after RAIT compared with conceptions that occurred 12 to 23 months after RAIT. The abortion rates based on the interval between RAIT and conception were 60.6% for the interval of 0 to 5 months, 30.1% for 6 to 11 months, 27.4% for 12 to 23 months, and 31.9% for 24 months or more. Conclusions and Relevance These large-scale real-world data indicate that receipt of RAIT before pregnancy does not appear to be associated with increases in adverse pregnancy outcomes when conception occurs 6 months or more after treatment.
DOI
10.1001/jamainternmed.2019.4644
Appears in Collections:
ETC > ETC
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE