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This version published online on June 16, 2009 Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2009-0012
Submitted on January 5, 2009 Association of parathyroid adenoma and pregnancy with pre-eclampsiaHella Hultin MD,Department of Surgical Sciences, University Hospital, Uppsala, Sweden; Department of Women's and Children's Health, University Hospital, Uppsala, Sweden; Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden; Clinical Research Centre, Örebro University Hospital, Örebro, Sweden; Department of Primary Care and Social Medicine, Charing Cross Hospital, Imperial College, London, UK; Department of Surgery, Östersund Hospital, Sweden; County Hospital, Kalmar, Sweden * To whom correspondence should be addressed. E-mail: per.hellman{at}surgsci.uu.se.
Objective: Case reports have described associations between calcium metabolism disturbances and primary hyperparathyroidism with pre-eclampsia, suggesting parathyroid involvement in pre-eclampsia aetiology. This study examines whether parathyroid adenoma, the main cause of hyperparathyroidism, diagnosed and treated prior to pregnancy is associated with pre-eclampsia. Design: Register-based study to assess the association between parathyroid adenoma and subsequent pre-eclampsia. Setting: Births among Sweden's general population. Population: 52 women with a diagnosis of parathyroid adenoma and 519 without, who had a subsequent singleton pregnancy between 1973 and 1997. Methods: Conditional logistic regression investigating the association of parathyroid adenoma with subsequent pre-eclampsia in the first singleton pregnancy with adjustment for potential confounding factors. Main outcome measure: A diagnosis of pre-eclampsia that does not include women with prior chronic hypertension. To ensure that treatment of parathyroid adenoma was completed prior to pregnancy, those with a diagnosis of parathyroid adenoma made less than two years prior to delivery (and the matched comparison women) were excluded. Results: Statistically, parathyroid adenoma prior to delivery is significantly (p<0.001) associated with pre-eclampsia, producing an adjusted odds ratio of 6.89 (95% confidence interval: 2.30, 20.58). Conclusion: A history of parathyroid adenoma should be viewed as a risk for pre-eclampsia.
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