Pregnancy Could Exacerbate Outcomes of Thyroid and Parathyroid Surgery

Pregnant women are at increased risk for endocrine and general complications, and are likely to have a longer hospital stay following thyroid and parathyroid surgery, according to a new study.

Researches from Yale University School of Medicine (New Haven, CT, USA) conducted a retrospective cross-sectional study and analyzed data from the U.S. Health Care Utilization Project Nationwide Inpatient Sample (HCUP-NIS) of 201 pregnant women whom underwent a thyroid or parathyroid procedure between 1999 and 2005. The outcomes of these women were compared with those of 31,155 age-matched nonpregnant women. On average, the patients were 29 years of age, and 60% were Caucasian; 46% of the patients had thyroid cancer and 25% of the surgical cases involved emergent or urgent hospital admissions. The main outcome measures were fetal, maternal, and surgical complications, in-hospital mortality, median length of stay, and hospital costs.

The study results showed that the pregnant women were roughly twice as like to experience an endocrine complication than were nonpregnant women (15.9% versus 8.1%). Likewise, general complications were more common in pregnant women (11.4% compared to 3.6%). The pregnant patients spent a median of two days in the hospital, compared with only one day for the nonpregnant patients. On multivariate analysis, pregnancy doubled the odds of surgical complication, increased the length of stay by 0.3 days, and increased the hospital cost by an average of US$300. Surgeon volume, patient race, and insurance status were also independent predictors of clinical and economic outcomes. The study was published in the May 2009 issue of Archives of Surgery.

"These findings are important because most thyroid and parathyroid disease occurs in women, with a significant proportion during the childbearing years," concluded lead author SreyRam Kuy, M.D., and colleagues of the division of endocrine surgery. "Pregnant women have worse clinical and economic outcomes following thyroid and parathyroid surgery than nonpregnant women, with disparities in outcomes based on race, insurance, and access to high-volume surgeons."

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