Adherence to treatment for hypothyroidism in pregnancy and relationship with thyrotropin control: a retrospective observational cohort study
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Abstract
BACKGROUND: Hypothyroidism is the second most common endocrinological disease during pregnancy, with percentages that can range between 3.2 and 5.5%. A good maternal and foetal health outcome depends on thyroid hormone replacement therapy. The goal of such therapy is to maintain thyrotropin (TSH) in a range that is specific for pregnant women and varies between the trimesters of pregnancy. In our study, we wanted to analyse the adherence to hypothyroidism treatment among pregnant women and to evaluate the degree of control of the disease. METHODS: We performed a retrospective observational cohort study in pregnant women between 2012 and 2018 in the Lleida health region. Therapeutic adherence was analysed by the proportion of days covered (PDC). The relationship with other variables was assessed using the regression coefficients and their 95% confidence interval (CI). RESULTS: We examined a sample of 17,281 women, representing more than 92% of the pregnant women in the Lleida health region in the period analysed. Among this sample, the mean prevalence of hypothyroidism was 6.52% (0.07% clinical and 6.45% subclinical). 3.3% of the 17,281 pregnant women were treated. Among them, the mean adherence score was 79.6 ± 22.2. Of these, 54% presented high adherence. The latter had a higher mean age and better TSH control, in comparison to the ones showing low adherence. CONCLUSIONS: Half of the treated patients had good adherence to treatment and a better TSH control, in comparison to the others. Most of them achieved a good control at the third trimester of pregnancy.
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Adherence was not satisfying even in women with hypothyroidism who were pregnant, 46% of whom took <80% of the prescribed LT4.
“Adherence was not satisfying even in women with hypothyroidism who were pregnant, 46% of whom took <80% of the prescribed LT4 (126).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [126]
A study found that only 54.1% of pregnant women achieved adequate treatment adherence, possibly because of concurrent nutritional supplements.
“A study showed that only 54.1% of pregnant women achieved adequate treatment adherence, possibly due to concurrent use of nutritional supplements.56”
From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [56]
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- Authors
- Siscart, J., Orós, M., Serna, M. C., Perejón, D., Galván, L., & Ortega, M.
- Affiliations
- Universitat de Lleida (ES)
- Departament de Salut (ES)
- Corresponding author
- Siscart, Júlia
- Ortega, Marta
- Venue
- BMC Pregnancy and Childbirth
- Published
- 2022-03-01
- Volume
- 22
- Issue
- 1
- Pages
- 168-168
- ISSN
- 1471-2393 (ISSN-L)
- PMC
- PMC8886742
- OpenAlex
- W4221115248
- Cited by
- 20
- References
- 28
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 3
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Pregnancy and Childbirth (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Repositori ObertUDL (University of Lleida) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- hypothyroidism in pregnancy, medication adherence, thyroid hormone replacement, proportion of days covered, subclinical hypothyroidism, maternal and fetal outcomes
- MeSH terms
- Adult, Female, Humans, Hypothyroidism, Patient Compliance, Pregnancy, Pregnancy Complications, Pregnancy Trimesters, Retrospective Studies, Spain, Thyrotropin, Thyroxine, Cohort Studies, Hormone Replacement Therapy
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