Pregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic review

Abstract Objective Graves’ disease (GD) patients treated with radioactive iodine may face health risks from potential radiation exposure, both for themselves and their offspring. This systematic review aims to comprehensively evaluate the association between prior radioactive iodine (RAI) therapy fo...

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Main Authors: Churun Xu, Lingge Wei, Peng Xie
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Thyroid Research
Subjects:
Online Access:https://doi.org/10.1186/s13044-025-00242-x
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author Churun Xu
Lingge Wei
Peng Xie
author_facet Churun Xu
Lingge Wei
Peng Xie
author_sort Churun Xu
collection DOAJ
description Abstract Objective Graves’ disease (GD) patients treated with radioactive iodine may face health risks from potential radiation exposure, both for themselves and their offspring. This systematic review aims to comprehensively evaluate the association between prior radioactive iodine (RAI) therapy for GD and subsequent pregnancy outcomes in women of childbearing age. Methods A search of the bibliographic databases PubMed/MEDLINE and Web of Science was conducted up to December 2024 to identify relevant studies. Results The final systematic review included 1055 patients from 5 articles, all of which were retrospective cohort studies. Two studies reported the incidence of miscarriage after RAI treatment of 2.3% (3/130) and 22.2% (6/27). One study indicated that the miscarriage rate in the RAI group was not significantly different from that in the control groups, while the other did not provide a statistical comparison between groups. Two studies reported the incidence of neonatal hyperthyroidism (NH) after RAI therapy of 11.3% (5/44) and 5.5% (8/145). Both studies indicated that high levels of serum TRAb during late pregnancy were significantly associated with NH (P < 0.05). One study reported the incidence of postpartum thyrotoxicosis (PT) after RAI therapy of 2.1%. Compared with surgical treatment and ATD treatment, patients with RAI therapy had a significantly lower incidence of PT (P < 0.05). Conclusion Based on the limited evidence from retrospective studies, current data does not demonstrate a statistically significant increase in the risk of miscarriage or postpartum thyrotoxicosis following RAI therapy, compared to ATDs or surgical treatment. Elevated maternal TRAb levels in late pregnancy were strongly associated with neonatal hyperthyroidism. However, the small sample sizes and heterogeneity in study designs preclude definitive conclusions. Further prospective studies are required to establish more comprehensive and reliable conclusions and to evaluate more pregnancy outcomes.
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spelling doaj-art-82d5b75f032c40b8b7c74e99536185642025-08-20T03:45:11ZengBMCThyroid Research1756-66142025-06-011811810.1186/s13044-025-00242-xPregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic reviewChurun Xu0Lingge Wei1Peng Xie2Department of Nuclear Medicine, The Third Hospital, Hebei Medical UniversityDepartment of Nuclear Medicine, The Third Hospital, Hebei Medical UniversityDepartment of Nuclear Medicine, The Third Hospital, Hebei Medical UniversityAbstract Objective Graves’ disease (GD) patients treated with radioactive iodine may face health risks from potential radiation exposure, both for themselves and their offspring. This systematic review aims to comprehensively evaluate the association between prior radioactive iodine (RAI) therapy for GD and subsequent pregnancy outcomes in women of childbearing age. Methods A search of the bibliographic databases PubMed/MEDLINE and Web of Science was conducted up to December 2024 to identify relevant studies. Results The final systematic review included 1055 patients from 5 articles, all of which were retrospective cohort studies. Two studies reported the incidence of miscarriage after RAI treatment of 2.3% (3/130) and 22.2% (6/27). One study indicated that the miscarriage rate in the RAI group was not significantly different from that in the control groups, while the other did not provide a statistical comparison between groups. Two studies reported the incidence of neonatal hyperthyroidism (NH) after RAI therapy of 11.3% (5/44) and 5.5% (8/145). Both studies indicated that high levels of serum TRAb during late pregnancy were significantly associated with NH (P < 0.05). One study reported the incidence of postpartum thyrotoxicosis (PT) after RAI therapy of 2.1%. Compared with surgical treatment and ATD treatment, patients with RAI therapy had a significantly lower incidence of PT (P < 0.05). Conclusion Based on the limited evidence from retrospective studies, current data does not demonstrate a statistically significant increase in the risk of miscarriage or postpartum thyrotoxicosis following RAI therapy, compared to ATDs or surgical treatment. Elevated maternal TRAb levels in late pregnancy were strongly associated with neonatal hyperthyroidism. However, the small sample sizes and heterogeneity in study designs preclude definitive conclusions. Further prospective studies are required to establish more comprehensive and reliable conclusions and to evaluate more pregnancy outcomes.https://doi.org/10.1186/s13044-025-00242-xGraves’ diseasePregnancy outcomeRadioiodine therapyTSH receptor antibodyPostpartum thyrotoxicosis
spellingShingle Churun Xu
Lingge Wei
Peng Xie
Pregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic review
Thyroid Research
Graves’ disease
Pregnancy outcome
Radioiodine therapy
TSH receptor antibody
Postpartum thyrotoxicosis
title Pregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic review
title_full Pregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic review
title_fullStr Pregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic review
title_full_unstemmed Pregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic review
title_short Pregnancy outcome following radioactive iodine therapy for Graves’ disease in women of childbearing age: a systematic review
title_sort pregnancy outcome following radioactive iodine therapy for graves disease in women of childbearing age a systematic review
topic Graves’ disease
Pregnancy outcome
Radioiodine therapy
TSH receptor antibody
Postpartum thyrotoxicosis
url https://doi.org/10.1186/s13044-025-00242-x
work_keys_str_mv AT churunxu pregnancyoutcomefollowingradioactiveiodinetherapyforgravesdiseaseinwomenofchildbearingageasystematicreview
AT linggewei pregnancyoutcomefollowingradioactiveiodinetherapyforgravesdiseaseinwomenofchildbearingageasystematicreview
AT pengxie pregnancyoutcomefollowingradioactiveiodinetherapyforgravesdiseaseinwomenofchildbearingageasystematicreview