Adverse effects of prenatal methimazole exposure

BACKGROUND

A specific phenotype of methimazole (MMI) induced malformations has recently been postulated. MMI embryopathy is characterized by minor dysmorphic features, choanal atresia and/or esophageal atresia, growth retardation, and developmental delay.

METHODS

We prospectively studied the outcome of pregnancy in 241 women counseled by 10 Teratology Information Services (TIS) of the European Network of Teratology Information Services (ENTIS) because of MMI exposure, and compared them with those of 1,089 pregnant women referred to TIS because of exposure to nonteratogenic drugs (control group). Information was obtained by mail or telephone interview.

RESULTS

There was no increase in the general rate of major anomalies or of spontaneous or induced abortions in the MMI-exposed group in comparison with the control group. Two newborns were affected with one of the major malformations that are part of the postulated embryopathy.

CONCLUSIONS

The results of this study indicate that choanal as well as esophageal atresia may have a higher incidence than expected in fetuses exposed to MMI between 3 and 7 gestational weeks. Until further data are available, thyrotoxicosis should be treated with propylthiouracil, as it is apparently safer for use during the fertile period.

Effect of 6 month supplementation with different combinations of an association of antioxidant nutrients on biochemical parameters and markers of the antioxidant defence system in the elderly. The Geriatrie/Min.Vit.Aox Network

OBJECTIVES

To study the effect of supplementation with an association of small physiological amounts of antioxidant nutrients upon biochemical parameters and indicators of oxidative stress and antioxidant enzymes.

DESIGN

The study included a double-blind placebo-controlled design.

SETTING

Nursing homes in different areas in France.

SUBJECTS

575 elderly long term hospitalized subjects aged 65-103 years.

INTERVENTION

Four groups were compared. They received daily: (V) vitamins (vitamin E, 15 mg and vitamin C, 120 mg) and beta-carotene, 6 mg; (T) trace elements (zinc, 20 mg, selenium, 100 micrograms); (VT) vitamins associated with trace elements; or (P) a placebo. Biological markers of vitamin and trace element status, and free radical parameters were measured initially and after 6 months of supplementation.

RESULTS

An analysis of variance indicated a significant effect of vitamin supplementation on serum alpha-tocopherol, beta-carotene and vitamin C, a significant effect of trace element supplementation on serum zinc and both a significant trace element and a vitamin-trace element interaction on serum selenium. We observed significant effects of both trace element and vitamin supplementation on GPx activity (P < 0.01), an effect of vitamin supplementation on SOD activity (P < 0.05).

CONCLUSION

Our results indicate that short-term supplementation with moderate doses of antioxidant vitamins and trace elements in elderly subjects clearly improves both non-enzymatic (alpha-tocopherol, beta-carotene, vitamin C) levels and enzymatic antioxidant (GPx and SOD) activity.

[Prevention of mineral deficiencies (iron, calcium and magnesium)]

The calcium, magnesium and iron intakes provided by food must be sufficient to fulfil the physiological demands of each individual, to avoid the clinical manifestations of mineral deficiencies and to ensure an optimal state of health. For these reasons, it is desirable to ensure a sufficient calcium intake (notably by milk products) at all ages and particularly in children, adolescents and young adults up to the age of 25 (and also in elderly people to prevent osteoporosis); to recommend the consumption of magnesium-rich foods, such a little sifted cereals and dry vegetables to ensure sufficient intakes; to prescribe pharmaceutical preparations on iron systematically in pregnant women and by repeated courses in infants aged 10 to 36 months (to avoid complications due to iron deficiency and notably its harmful influence on haematopoiesis). The consumption of "second age" milks for older children must also be encouraged. Finally, the consumption of foodstuffs with a high vitamin C content should be recommended as it increases the bioavailability of nutritional iron, and the consumption of substances, such as tea and coffee, which inhibit iron absorption must be reduced.