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Addison’s disease increases risk for adverse pregnancy outcomes
Björnsdottir S. J Clin Endocrinol Metab. 2010;doi:10.1210/jc.2010-0108.
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Women with diagnosed and undiagnosed autoimmune Addison’s disease are at increased risk for preterm birth, low birth weight and other unfavorable pregnancy outcomes, according to results of a Swedish population-based cohort study.
Because autoimmune Addison’s disease typically affects younger women, researchers compared pregnancy outcomes in women of reproductive age (15 to 47 years) with the results with control women. Using the Swedish National Patient Register and the Total Population Register, the researchers identified 1,188 women with autoimmune Addison’s disease and 11,879 age-matched women who served as controls. All women delivered infants between 1973 and 2006.
According to the results, for infants born to mothers who delivered 3 years or less before being diagnosed with autoimmune Addison’s disease, the OR for preterm birth was 2.40 (95% CI, 1.27-4.53); the OR for low birth weight was 3.50 (95% CI, 1.83-6.67); and the OR for cesarean section was 1.74 (95% CI, 1.02-2.96).
“Women with deliveries 3 years or less before an autoimmune Addison’s diagnosis may have undiagnosed autoimmune Addison’s disease during pregnancy, and these women had increased risks of preterm delivery and of having a low birth weight,” the researchers wrote.
Women who delivered after a diagnosis of autoimmune Addison’s disease were at increased risk for cesarean delivery (adjusted OR=2.35; 95% CI, 1.68-3.27) and preterm delivery (adjusted OR=2.61; 95% CI, 1.69-4.05) compared with controls.
In addition, women with autoimmune Addison’s disease had a reduced parity compared with other women.
Risks for congenital malformations or infant death were not associated with diagnosed or undiagnosed autoimmune Addison’s disease.
The researchers said the overall risks for adverse pregnancy outcomes “must be considered low” and most of the women with autoimmune Addison’s disease had normal pregnancy outcomes.
However, they concluded: “Our findings are of importance for antenatal counseling in women with autoimmune Addison’s disease. Careful monitoring is needed to observe signs of fetal growth retardation with potentially harmful short- and long-term consequences for the infant.”
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