Journal
MEDICINE
Volume 95, Issue 5, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MD.0000000000002685
Keywords
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Funding
- National Taiwan University Hospital
- Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence [MOHW105-TDU-B-212-133019]
- China Medical University Hospital
- Academia Sinica Taiwan Biobank Stroke Biosignature Project [BM10501010037]
- NRPB Stroke Clinical Trial Consortium (MOST) [104-2325-B-039-005]
- Tseng-Lien Lin Foundation, Taichung, Taiwan
- Taiwan Brain Disease Foundation, Taipei, Taiwan
- Katsuzo and Kiyo Aoshima Memorial Funds, Japan
- CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan
- Health, and welfare surcharge of tobacco products, China Medical University Hospital Cancer Research Center of Excellence (Taiwan) [MOHW104-TDU-B-212-124-002]
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The aim of this study was to evaluate the influence of I-131 therapy on pregnancy outcome in patients that received therapeutic I-131 doses for thyroid cancer in Taiwan. This nationwide population-based cohort study was based on data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database. We identified 11,708 women with thyroid cancer (>= 15 and <= 50 years of age) by International Classification of Diseases, Ninth Revision, Clinical Modification codes. Patients were divided into 2 cohorts: I-131 therapy cohort and non-I-131 therapy cohort. The mean follow-up period was 6.08 years for the I-131 cohort and 6.87 years for the non-I-131 cohort. The case cohort and the control cohort comprised 775 and 716 pregnant patients, respectively. The overall incidence of pregnancy was significantly lower in the I-131 cohort (adjusted HR = 0.77, 95% CI = 0.70-0.86) and it was also observed when the patients were stratified according to age (HR = 0.73, 95% CI = 0.64-0.83 in 25-34 years; HR = 0.63, 95% CI = 0.49-0.82 in 35-44 years). Patients in the I-131 cohort had a lower successful delivery rate, particularly among patients in 25 to 34 years (OR = 0.60, 95% CI = 0.45-0.80). No significant difference was observed for adverse pregnancy conditions between 2 cohorts. I-131 therapy is associated with decreased pregnancy and successful delivery rates. The underlying mechanism likely involves physician recommendation, patient's psychological issue, and potential impact of I-131 treatment on reproductive health. Further investigation is needed.
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