Antithyroid Drugs and Risk for Congenital Malformations: To Treat or Not to Treat?

In a Korean national cohort of pregnant women with Graves disease, methimazole carried greater risk than propylthiouracil.

Untreated Graves disease in pregnant women can cause pregnancy loss and serious maternal complications; hence, antithyroid drugs (ATDs) during early pregnancy have long been advocated. Propylthiouracil (PTU) is preferred because of concerns about teratogenicity associated with methimazole (MMI); still, both agents cross the placenta and can affect organogenesis. To examine the association between first-trimester use of ATDs and congenital malformations, investigators utilized the Korean National Health Insurance database to study 2.9 million completed pregnancies linked to outcomes in liveborn infants from 2008 through 2014.

In 12,891 pregnancies (0.45%), mothers received first-trimester ATDs. PTU was prescribed to 77.0% of affected women, M…

Reviewing Author

Robert W. Rebar, MD

Disclosures

Consultant/Advisory BoardMyovant Sciences, Inc.

Editorial BoardsEndoText; Clinical OB/GYN Alert

Leadership Positions in Professional SocietiesAmerican Society for Reproductive Medicine (Member, Ethics Committee)

Robert W. Rebar, MD

Disclosures

Consultant/Advisory BoardMyovant Sciences, Inc.

Editorial BoardsEndoText; Clinical OB/GYN Alert

Leadership Positions in Professional SocietiesAmerican Society for Reproductive Medicine (Member, Ethics Committee)

Antithyroid Drugs and Risk for Congenital Malformations: To Treat or Not to Treat?

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Reviewing Author