scholarly journals High Body Mass Index Is an Indicator of Maternal Hypothyroidism, Hypothyroxinemia, and Thyroid-Peroxidase Antibody Positivity during Early Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Cheng Han ◽  
Chenyan Li ◽  
Jinyuan Mao ◽  
Weiwei Wang ◽  
Xiaochen Xie ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Pregnant Women ◽  
Body Mass ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Maternal Thyroid ◽  
High Bmi

Background. Maternal thyroid dysfunction in early pregnancy may increase the risk of adverse pregnancy complications and neurocognitive deficiencies in the developing fetus. Currently, some researchers demonstrated that body mass index (BMI) is associated with thyroid function in nonpregnant population. Hence, the American Thyroid Association recommended screening thyroid function in obese pregnant women; however, the evidence for this is weak. For this purpose, our study investigated the relationship between high BMI and thyroid functions during early pregnancy in Liaoning province, an iodine-sufficient region of China.Methods. Serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) concentration, urinary iodine concentration (UIC), and BMI were determined in 6303 pregnant women.Results. BMI ≥ 25 kg/m2may act as an indicator of hypothyroxinemia and TPOAb positivity and BMI ≥ 30 kg/m2was associated with increases in the odds of hypothyroidism, hypothyroxinemia, and TPOAb positivity. The prevalence of isolated hypothyroxinemia increased among pregnant women with BMI > 24 kg/m2.Conclusions. High BMI during early pregnancy may be an indicator of maternal thyroid dysfunction; for Asian women whose BMI > 24 kg/m2and who are within 8 weeks of pregnancy, thyroid functions should be assessed especially.

scholarly journals Effect of gestational diabetes mellitus on maternal thyroid function and body mass index

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1746
Author(s):  
Elrazi A. Ali ◽  
Hala Abdullahi ◽  
Duria A. Rayis ◽  
Ishag Adam ◽  
Mohamed F. Lutfi
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Thyroid Hormones ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Body Mass ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Maternal Thyroid

Background: The exact influences of thyroid functions on body mass index (BMI) are ill-defined in euthyroid pregnant women with gestational diabetes mellitus (GDM). Objectives: To investigate the effect of GDM on maternal thyroid functions and BMI. Methods:  A case- control study was conducted in Saad Abualila Hospital, Khartoum, Sudan June to August 2015. Cases included women with GDM and healthy pregnant women as controls. Thyroid hormones [thyroid-stimulating hormone (TSH), free tri-iodothyronine (FT3), and free thyroxine (FT4)] and anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were measured. Results:  BMI was significantly increased in GDM patients (26.3 (2.7) Kg/m2) compared with the control group (24.3(1.8) Kg/m2, P = 0.001). Levels of FT3 and FT4 were significantly decreased in GDM patients (0.632 (0.408 ─ 1.074) pg/ml; 0.672 (0.614 ─ 0.960) ng/dl) compared with the healthy pregnant women (0.820 (0.510─1.385) pg/ml, P = 0.021; 0.840 (0.767─1.200) ng/dl, P < 0.001). In contrast, anti-TPO and anti-TG were significantly higher in GDM patients (11.13 (7.969 ─13.090) IU/ml; 14.40 (10.91─20.69) IU/ml) compared with the control group (8.90 (6.375─10.48 IU/ml, P = 0.022; 10.50 (8.2─13.95) IU/ml, P = 0.010). BMI correlated negatively with FT3 (r = ─ 0. 375, P = 0.002) and FT4 (r = ─ 0. 316, P = 0.009) and positively with anti-TPO (r = 0.361, P = 0.002) and anti-TG (r = 0.393, P = 0.010). Conclusion: The present results add further evidence for decreased free thyroid hormones, increased anti-thyroid autoantibodies and higher BMI in patients with GDM compared to healthy pregnant women. BMI correlated directly with FT3 and FT4, but failed to demonstrate significant association with TSH.

Thyroid function in pregnant women; relation to Gestational Diabetes Mellitus (GDM) and Body Mass Index (BMI)

2018 ◽  
Author(s):  
George Simeakis ◽  
Evangelia Vogiatzi ◽  
Panagiota Konstantakou ◽  
Evangelia Zapanti ◽  
Katerina Saltiki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Body Mass Index ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Body Mass ◽  
Thyroid Function

Prevalence of abnormal thyroid stimulating hormone and thyroid peroxidase antibody-positive results in a population of pregnant women in the Samara region of the Russian Federation

2005 ◽  
Vol 43 (11) ◽  
Author(s):  
Frank A. Quinn ◽  
Gennady N. Gridasov ◽  
Sergey A. Vdovenko ◽  
Natalia A. Krasnova ◽  
Nadezhda V. Vodopianova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Russian Federation ◽  
Gestational Age ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
The Russian Federation ◽  
Maternal Thyroid ◽  
Positive Results ◽  
Stimulating Hormone

AbstractUndiagnosed thyroid disease is a common problem with significant public health implications. This is especially true during pregnancy, when the health of both the mother and the developing child can be adversely affected by abnormal maternal thyroid function. Measurement of serum thyroid stimulating hormone (TSH) and thyroid peroxidase antibodies (TPO-Ab) are two common ways to assess maternal thyroid status. The objective of our study was to determine the prevalence of abnormal TSH and TPO-Ab tests in a population of pregnant women in the Samara region of the Russian Federation. Serum samples were obtained from 1588 pregnant women as part of their routine antenatal care. TSH and TPO-Ab were measured, and trimester-specific reference values for TSH (2.5–97.5 percentiles) were calculated using TPO-Ab-negative women. TSH results outside these ranges were considered abnormal; TPO-Ab levels outside the manufacturer's reference range (>12IU/mL) were considered abnormal. Overall, the prevalence of abnormal results was 6.3% for TSH and 10.7% for TPO-Ab. High TSH (>97.5 trimester-specific percentile) and TPO-Ab-positive results were most common in the first trimester (5.7% and 13.8%, respectively). TSH levels were associated with gestational age and TPO-Ab status, and with maternal age in TPO-Ab-negative women. TPO-Ab status was associated with both maternal and gestational age. Women with TSH >2.5mIU/L had a significantly increased risk of being TPO-Ab-positive, and this risk increased with age. Based on our data, we conclude that abnormal TSH and TPO-Ab are common in pregnant women of the Samara region. Given the association of thyroid dysfunction to adverse pregnancy outcomes, screening of this population for abnormal thyroid function should be considered.

scholarly journals Thyroid Peroxidase Antibody and Screening for Postpartum Thyroid Dysfunction

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mohamed A. Adlan ◽  
Lakdasa D. Premawardhana
Keyword(s):  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Screening Tool ◽  
Cost Effective ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Screening Strategies ◽  
Considerable Morbidity ◽  
Postpartum Thyroid Dysfunction

Postpartum thyroid dysfunction (PPTD) is a common disorder which causes considerable morbidity in affected women. The availability of effective treatment for hypothyroid PPTD, the occurrence of the disease in subsequent pregnancies and the need to identify subjects who develop long term hypothyroidism, has prompted discussion about screening for this disorder. There is currently no consensus about screening as investigations hitherto have been variable in their design, definitions and assay frequency and methodology. There is also a lack of consensus about a suitable screening tool although thyroid peroxidase antibody (TPOAb) is a leading contender. We present data about the use of TPOAb in early pregnancy and its value as a screening tool. Although its positive predictive value is moderate, its sensitivity and specificity when used in early pregnancy are comparable or better compared to other times during pregnancy and the postpartum period. Recent studies have also confirmed this strategy to be cost effective and to compare favourably with other screening strategies. We also explore the advantages of universal screening.

scholarly journals Engagement with and outcomes of a Midwifery-led intervention group for pregnant women of high body mass index

2016 ◽  
Vol 9 (3) ◽  
pp. 120-125 ◽  
Author(s):  
Sarah R Chwah ◽  
Amanda Reilly ◽  
Beverley Hall ◽  
Anthony J O’Sullivan ◽  
Amanda Henry
Keyword(s):  
Body Mass Index ◽  
Pregnant Women ◽  
Body Mass ◽  
Intervention Group ◽  
Group Versus ◽  
High Body Mass Index ◽  
Breastfeeding Initiation ◽  
Retrospective Case ◽  
Significant Difference ◽  
High Bmi

Aims To compare pregnancy care, maternal and neonatal outcomes of women with Body Mass Index (BMI) >30 enrolled in a Weight Intervention Group versus other models of antenatal care. Methods Retrospective, case-control study of mothers with BMI >30 managed with a specialised programme versus age-matched women enrolled in standard models of care. Results One thousand, one hundred and fifteen of 9954 pregnant women with singleton pregnancies, had a BMI >30, of whom 9.6% enrolled in the intervention group. Compared to controls, the intervention group had superior implementation of local high BMI guidelines, including; nutritional /weight gain advice (86% vs. 46%, p < 0.001), regular weighing (80% vs. 33%, p < 0.001), lactation consultant referrals (8% vs. 1%, p = 0.02), third trimester anaesthetic review and ultrasound (50% vs. 20.9%, p = 0.04 and 55% vs. 43%). Initiation of breastfeeding was higher in the intervention group (100% vs. 90%, p = 0.001). No significant difference was noted in Caesarean rate (30% vs 32%) and birthweight (3538 g vs 3560 g). Conclusions Women with high BMI enrolled in a specialised antenatal management programme received increased care, and had superior breastfeeding initiation rates. However, engagement was poor, and no significant differences were noted in antenatal or postnatal complications, mode of birth or neonatal outcome.

scholarly journals The Presence of Thyroid Peroxidase Antibody Is Associated with Lower Placental Weight in Maternal Thyroid Dysfunction

2019 ◽  
Vol 249 (3) ◽  
pp. 231-236 ◽  
Author(s):  
Junko Ushijima ◽  
Seishi Furukawa ◽  
Hiroshi Sameshima
Keyword(s):  
Thyroid Dysfunction ◽  
Placental Weight ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Maternal Thyroid

Temporal trend of early pregnancy high body mass index in Australian women: risk factors and outcomes

2021 ◽  
Vol 29 (1) ◽  
pp. 10-18
Author(s):  
Marjan Khajehei ◽  
Hassan Assareh
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Body Mass ◽  
Early Pregnancy ◽  
High Body Mass Index ◽  
Tertiary Hospital ◽  
Reproductive Age ◽  
Smoking During Pregnancy ◽  
High Body ◽  
High Bmi

Background There is a shift toward the increasing weight gain among women of reproductive age. Aim To assess changes in the prevalence of high body mass index (BMI) (including both overweight and obese) in early pregnancy in Australian women, and its risk factors and association with selected birth outcomes from 2011–2017. Methods Records of pregnant women who received antenatal care and gave birth at an Australian tertiary hospital during 2011–2017 were evaluated and trends of high BMI were investigated. Results The risk of high BMI at early pregnancy increased by 3% annually and rose from 37% in 2011 to 44% in 2017. The risk of high BMI was greater in women who were more than 35 years old, multiparous, were smoking during pregnancy, and who had neurological disorders. High maternal BMI was associated with greater risks of having assisted conception, caesarean section and larger neonate. Conclusion The rate of high BMI in early pregnancy increased between 2011–2017.

scholarly journals Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals

2007 ◽  
Vol 157 (4) ◽  
pp. 509-514 ◽  
Author(s):  
Rt Stricker ◽  
M Echenard ◽  
R Eberhart ◽  
M-C Chevailler ◽  
V Perez ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Gestational Age ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Reference Intervals ◽  
Specific Reference ◽  
Thyroid Function Tests ◽  
Laboratory Evidence ◽  
Maternal Thyroid

Background: Maternal thyroid dysfunction has been associated with a variety of adverse pregnancy outcomes. Laboratory measurement of thyroid function plays an important role in the assessment of maternal thyroid health. However, occult thyroid disease and physiologic changes associated with pregnancy can complicate interpretation of maternal thyroid function tests (TFTs). Objective and methods: To 1) establish the prevalence of laboratory evidence for autoimmune thyroid disease (AITD) in pregnant women; 2) establish gestational age-specific reference intervals for TFTs in women without AITD; and 3) examine the influence of reference intervals on the interpretation of TFT in pregnant women. Serum samples were collected from 2272 pregnant women, and TFT performed. Gestational age-specific reference intervals were determined in women without AITD, and then compared with the non-pregnant assay-specific reference intervals for interpretation of testing results. Results: Thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin antibodies (Tg-Ab) were positive in 10.4 and 15.7% of women respectively. TPO-Ab level was related to maternal age, but TPO-Ab status, Tg-Ab status, and Tg-Ab level were not. Women with TSH > 3.0 mIU/l were significantly more likely to be TPO-Ab positive. Gestational age-specific reference intervals for TFT were significantly different from non-pregnant normal reference intervals. Interpretation of TFT in pregnant women using non-pregnant reference intervals could potentially result in misclassification of a significant percentage of results (range: 5.6–18.3%). Conclusion: Laboratory evidence for thyroid dysfunction was common in this population of pregnant women. Accurate classification of TFT in pregnant women requires the use of gestational age-specific reference intervals.

Classification of maternal thyroid function in early pregnancy using repeated blood samples

2021 ◽  
Author(s):  
Louise Knøsgaard ◽  
Stig Andersen ◽  
Annebirthe Bo Hansen ◽  
Peter Vestergaard ◽  
Stine Linding Andersen
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Specific Reference ◽  
Reference Ranges ◽  
Sample Median ◽  
Blood Samples ◽  
Reference Limit ◽  
Maternal Thyroid

Objective: The assessment of maternal thyroid function in early pregnancy is debated. It is well-established that pregnancy-specific reference ranges preferably should be used. We speculated if the use of repeated blood samples drawn in early pregnancy would influence the classification of maternal thyroid function. Design: Cohort study Methods: Pregnant women with repeated early pregnancy blood samples were identified in the North Denmark Region Pregnancy Cohort. Each sample was used for the measurement of TSH, free T4 (fT4), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab) (ADVIA Centaur XPT, Siemens Healthineers). Method- and pregnancy week-specific reference ranges were used for classification of maternal thyroid function. Results: Among 1,466 pregnancies included, 89 women had TSH above the upper reference limit in the first sample (median pregnancy week 8), and 44 (49.4%) of these similarly had high TSH in the second sample (median week 10). A total of 47 women had TSH below the lower reference limit in the first sample, and 19 (40.4 %) of these similarly had low TSH in the second sample. Regarding women classified with isolated changes in fT4 in the first sample, less than 20% were similarly classified as such in the second sample. The percentage agreement between the samples was dependent on the level of TSH in the first sample and the presence of TPO- and Tg-Ab. Conclusion: In a large cohort of pregnant women, the classification of maternal thyroid function varied considerably with the use of repeated blood samples. Results emphasize a focus on the severity of thyroid function abnormalities in pregnant women.

scholarly journals Thyroid function and autoimmunity in Danish pregnant women after an iodine fortification program and associations with obstetric outcomes

2015 ◽  
Vol 173 (6) ◽  
pp. 709-718 ◽  
Author(s):  
Sofie Bliddal ◽  
Malene Boas ◽  
Linda Hilsted ◽  
Lennart Friis-Hansen ◽  
Ann Tabor ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Thyroid Function ◽  
Gestational Age ◽  
Thyroid Dysfunction ◽  
Reference Intervals ◽  
Obstetric Outcome ◽  
Thyroid Status ◽  
Antibody Positivity ◽  
Maternal Thyroid

ObjectiveAberrations in maternal thyroid function and autoimmunity during pregnancy have been associated with negative obstetric outcome. In Denmark, a national iodine fortification program was implemented in the year 2000 with the aim to alleviate the mild-moderate iodine deficiency. Following the iodine implementation, there has been an increase in thyroid autoimmunity in the background population. This study investigates the thyroid status of pregnant Danish women following the iodine fortification program, and a possible association with preterm delivery.DesignHistorical cohort study of 1278 randomly selected pregnant Danish women attending the national Down's syndrome screening program.MethodsThe main outcome measures were thyroid status according to laboratory- and gestational-age-specific reference intervals, and association with risk of abnormal obstetric outcome. Antibody-positivity was defined as an antibody-level (thyroid peroxidase and/or thyroglobulin antibodies) above 60 U/ml.ResultsEstablishing laboratory-specific gestational-age-dependent reference intervals, we found a prevalence of maternal thyroid dysfunction of 10%–15.8% by use of the cut-off suggested by the American Thyroid Association. Thyroid dysfunction was significantly associated with antibody-positivity (P<0.05). No associations were found between preterm delivery and thyroid dysfunction (adjusted OR 0.6, 95% CI: 0.1–2.3) or autoimmunity (adjusted OR 1.1, 95% CI: 0.4–2.7).ConclusionsAfter the implementation of the Danish iodine fortification program, the prevalence of thyroid dysfunction and autoimmunity in Danish pregnant women is high – even higher by use of pre-established reference intervals from international consensus guidelines. However, no associations were found with abnormal obstetric outcome. Large randomized controlled trials are needed to clarify the benefit of treating slight aberrations in pregnant women's thyroid function.

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