Fertility and Pregnancy Outcomes in Primary Hyperparathyroidism: Observations From a Large Insured Population
Main finding · Pregnancy rateResult — go to the resultAdjusted rate ratio 0.89 95% CI 0.64–1.24Authors' conclusion
We observed no difference in pregnancy rates between women with or without PHPT. Performing parathyroidectomy before pregnancy or during the second trimester appears to be a safe and successful strategy, and adherence to this strategy may be most critical for patients with higher calcium levels (≥11.5 mg/dL [2.9 mmol/L]).
Study context
- Population
- Women aged 18 to 44 years, integrated health-care delivery system in Southern California, 2005–2020matched cohort
- Participants
- 386 vs 1,158
- Exposure
- Primary hyperparathyroidism (PHPT) vs eucalcemic controls
- PHPTn = 386
- Non-PHPTn = 1,158reference
- Outcome
- Achievement of pregnancy, pregnancy outcomes (abortion, maternal complications) and neonatal outcomes (hypocalcemia, need for intensive care)
Methodological detailsintegrated health-care delivery system
- Integrated health-care delivery system
Main finding
Pregnancy rate
Adjusted rate ratio
0.89
95% CI 0.64–1.24
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
Live births among pregnancies
P = 0.023
- Live births among pregnancies: 29 pregnancies with PHPT, 191 in controls
Neonatal outcomes
- Neonatal outcomes were similar
Live birth rates by timing of parathyroidectomy
- Parathyroidectomy prior to pregnancy (n = 22)
- 86.4%
- Parathyroidectomy during pregnancy (n = 5)
- 80%
- Parathyroidectomy after pregnancy/never (n = 24)
- 79.2%
- Live birth rates were similar
Spontaneous abortion with parathyroidectomy during pregnancy, peak calcium <11.5 mg/dL (2.9 mmol/L) at pregnancy entry
- No spontaneous abortions occurred
Original publication
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