Obstetrical and Neonatal Outcomes in Pregnant Women with Serum Thyroid-Stimulating Hormone (TSH) Levels >2.0 mU/Lvs.Those with TSH <2.0 in the First Trimester of Pregnancy

2011 ◽  
pp. OR15-4-OR15-4
Author(s):  
Shweta Achit ◽  
Tapasya Dhar ◽  
Kumkum Awasthi ◽  
Bharti Uppal ◽  
Jubbin Jagan Jacob
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
Neonatal Outcomes ◽  
First Trimester Of Pregnancy ◽  
Tsh Levels ◽  
Stimulating Hormone

The Diverse Upper Reference Limits of Serum Thyroid-Stimulating Hormone on the Same Platform for Pregnant Women in China

2019 ◽  
Vol 51 (4) ◽  
pp. 416-422
Author(s):  
Guocheng Wang ◽  
Guojun Zhang
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Diseases ◽  
Striking Difference ◽  
Prevalence Rates ◽  
Reference Limits ◽  
First Trimester Of Pregnancy ◽  
Stimulating Hormone

Abstract Objective To describe the diverse upper reference limits of serum thyroid stimulating hormone on the same platform for pregnant women in China. Methods The trimester-specific and population-specific TSH reference intervals for pregnant women were established, and then 5 reference intervals on the same platform in China were compared with the reference intervals derived from the present study and the manufacturer. Results The most striking difference in the upper reference limits of TSH among 5 reference intervals on the same platform was shown at the first trimester of pregnancy. The calculated regional prevalence rates of subclinical thyroid diseases varied using the data derived from 30,771 pregnant women who visited the largest obstetric center in our district from 2008 to 2018. Conclusion We reported differences among 7 reference intervals of TSH on the same platform and showed the changing population factors significantly affected them.

scholarly journals Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study

2019 ◽  
Vol 8 (9) ◽  
pp. 1288-1293 ◽  
Author(s):  
Jiashu Li ◽  
Aihua Liu ◽  
Haixia Liu ◽  
Chenyan Li ◽  
Weiwei Wang ◽  
...  
Keyword(s):  
Case Control Study ◽  
First Trimester ◽  
Case Control ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Thyroid Peroxidase ◽  
Spontaneous Miscarriage ◽  
Control Study ◽  
Tsh Levels ◽  
Stimulating Hormone

Thyroid dysfunction is a frequently found endocrine disorder among reproductively aged women. Subclinical hypothyroidism is the most common condition of thyroid disorders during pregnancy and is defined as manifesting a thyroid-stimulating hormone concentration exceeding the trimester-specific reference value, with a normal free thyroxine concentration. Here, we evaluated the prospective association between spontaneous miscarriage and first-trimester thyroid function. We conducted a case–control study (421 cases and 1684 controls) that was nested. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) status were measured. We found that higher TSH was related to spontaneous miscarriage (OR 1.21; 95% CI, 1.13–1.30, P < 0.001). Compared with women with TSH levels of 0.4–<2.5 mIU/L, the risk of miscarriage was increased in women with TSH levels of 2.5–<4.87 mIU/L (OR 1.47; 95% CI, 1.16–1.87) and TSH greater than 4.87 mIU/L (OR 1.97; 95% CI, 1.22–3.18). After controlling for the confounding factor, TPOAb positivity status and FT4, the results were similar. The present study showed that higher TSH was associated with miscarriage in early pregnancy. In fact, TSH levels between 2.5 and 4.87 mIU/L increased the risk for miscarriage, with TSH greater than 4.87 mIU/L increasing the risk even further.

scholarly journals SUBCLINICAL HYPOTHYROIDISM IN PREGNANCY; IS THERE A NEED FOR PHARMACOLOGICAL INTERVENTION?

2017 ◽  
Vol 9 (3) ◽  
pp. 186
Author(s):  
Shripad Hebbar ◽  
Sahan Kumar ◽  
Sapna Amin ◽  
Sneha Doizode
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Subclinical Hypothyroidism ◽  
First Trimester ◽  
Pharmacological Intervention ◽  
Complication Rates ◽  
Geographic Population ◽  
First Trimester Of Pregnancy ◽  
Tsh Levels

Objective: To find the prevalence of subclinical hypothyroidism in the first trimester of pregnancy and to compare the maternal and perinatal outcome in them with euthyroid mothers.Methods: The present study was a prospective observational case-control study done in a tertiary hospital over the period of one and half years. Pregnant women in the first trimester of pregnancy were tested for Thyroid Stimulating Hormone (TSH) levels and those who had TSH>2.5mIU/l, free T3 and free T4 estimation was carried out on the same sample. A total of 171 women could be followed up till delivery and their first-trimester thyroid profile was available for analysis. They were grouped into two groups, Group 1: all women with TSH level>2.5 mIU/l, considered to be hypothyroid (n=79), Group 2: women with euthyroid status with TSH levels 0.1 to 2.5 mIU/l (n=95). All the neonates delivered in the first group had cord blood TSH estimation.Results: In the study period, there were 2632 deliveries. The number of pregnant women with first trimester TSH levels>2.5 mIU/l were 79, giving the prevalence rate of 3 % for subclinical hypothyroidism during pregnancy. The obstetric complications observed were gestational hypertension 3.8%, gestational diabetes 6.3%, placenta praevia1.3% and preterm delivery 7.6%. The perinatal complications included Intrauterine growth restriction (IUGR) 1.3%, Low Birth Weight (LBW) 3.8%, perinatal asphyxia 2.5% and neonatal hypothyroidism 1.3%. Only preterm delivery appeared to be significantly associated with subclinical hypothyroidism.Conclusion: The observed complication rates were much similar, in fact, lesser with gestational diabetes, pregnancy hypertension, IUGR, LBW compared to global and Indian prevalence rates. This indicates that the cut-off for diagnosing subclinical hypothyroidism should be derived from TSH assays from the local geographic population and should guide the treating physician to establish appropriate TSH ranges where definite therapeutic intervention is required to improve the maternal and foetal outcome.

scholarly journals Establishment of assay method- and trimester-specific reference intervals for thyroid hormones during pregnancy in Chengdu, China

2020 ◽  
Author(s):  
Cheng Huang ◽  
Ying Wu ◽  
Linong Chen ◽  
Zhiya Yuan ◽  
Shuzhe Yang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Assay Method ◽  
Second Trimester ◽  
Third Trimester ◽  
Free Triiodothyronine ◽  
Stimulating Hormone

Abstract Background: The reference intervals of thyroid hormone will change at different stages of pregnancy because of physiological alterations. On the other hand, the reference intervals of hyroid hormone will also change in different detection systems due to manufacturer’s methodology as well as different race. The objective in this study was to establish the assay method- and trimester-specific reference intervals for thyroid stimulating hormone, free thyroxine, and free triiodothyronine for pregnant women in the Chengdu.Methods: A prospective, population-based cohort study involved 23701 reference samples of pregnant women during the three trimesters and 8646 non-pregnant women with pre-pregnancy clinical and laboratory tests. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid stimulating hormone, free thyroxine, and free triiodothyronine at each trimester of pregnant women according to ATA Guidelines.Results: The reference interval of thyroid stimulating hormone in the 2.5th and 97.5th percentiles has a significant increasing trend from first trimester, to second trimester, and to third trimester, which was 0.08-3.79 mIU/L for first trimester, and 0.12-3.95 mIU/L for second trimester, and 0.38-4.18 mIU/L for third trimester, respectively (P < 0.001). However, the reference intervals of free thyroxine and free triiodothyronine in the 2.5th and 97.5th percentiles have significant decreasing trends from first trimester, to second trimester, and to third trimester, which were 11.87-18.83 pmol/L and 3.77-5.50 pmol/L for first trimester, and 11.22-18.19 pmol/L and 3.60-5.41 pmol/L for second trimester, and 10.19-17.42 pmol/L and 3.37-4.79 pmol/L for third trimester, respectively (both P < 0.001).Conclusion: It is necessary to establish assay method- and trimester-specific reference intervals for thyroid stimulating hormone, free thyroxine, and free triiodothyronine because the reference intervals of these thyroid hormones are significantly different at different stages of pregnancy.

scholarly journals Assessment of Thyroid Peroxidase Antibody And Thyroid Stimulating Hormone In First Trimester Of Pregnancy

2013 ◽  
Vol 12 (2) ◽  
pp. 164-171
Author(s):  
Nishat Un Nahar ◽  
Zeba Un Naher ◽  
Md. Ashanul Habib ◽  
Forhadul Hoque Mollah
Keyword(s):  
Preterm Birth ◽  
Post Partum ◽  
Medical Science ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
First Trimester Of Pregnancy ◽  
Serum Tsh ◽  
Stimulating Hormone

Introduction: Maternal thyroid dysfunction during pregnancy has been associated with a number of adverse outcomes, like preterm birth, placental abruption, foetal death and impaired neurological development in the child. Simultaneously the presence of antibody to thyroid peroxidase results miscarriage, preterm birth and maternal post partum thyroid disease. Post partum thyroiditis is closely associated with the presence of antibodies to thyroid peroxidase (TPO). Indeed if a pregnant woman is positive for TPO antibodies early in pregnancy, her chances of developing post partum thyroiditis is 30-52%. Objective: To find out the level of TPO-Ab and thyroid status in first trimester of pregnancy. Method: The cross sectional study was designed in Department of Biochemistry, BSMMU, Dhaka. Following inclusion and exclusion criteria 200 sample was selected by purposive and convenient sampling. The study parameters were- thyroid peroxidase antibody (TPO-Ab); serum thyroid stimulating hormone (TSH); serum free thyroxin (FT4). Results: 43 (21.5%) pregnant women of first trimester was found to be TPO-Ab positive, among these 43 subjects 16 (8.0%) had raised TSH i.e. >2.5 mIU/L and 27 had TSH level <2.5 mIU/L. Low serum FT4 was in 9 (4.5%) subjects. The study revealed that, there was a significant positive correlation between positive TPO-Ab (>12 IU/mL) and serum TSH level of study subjects and there was negative correlation between serum TSH (>2.5 mIU/L) and serum FT4 in study subjects. Conclusion: TPO-Ab positivity in first trimester of pregnancy and TPOAb positivity was associated with higher TSH and low FT4 level. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 164-170 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14945

scholarly journals Prevalence of anti-thyroid peroxidase antibodies in the first trimester pregnancy and its impact on maternal and fetal outcomes in a tertiary care centre in Bangalore

2021 ◽  
Vol 8 (2) ◽  
pp. 182-187
Author(s):  
Shruthi H S ◽  
Nalini Arunkumar ◽  
Ravi N Patil
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Thyroid Peroxidase ◽  
American Thyroid Association ◽  
Tertiary Care Centre ◽  
Mother And Child ◽  
Tsh Levels

: Hypothyroidism during pregnancy has an adverse effect on both mother and child. The maternal and foetal risk is higher in TPOAb (Thyroid peroxidase antibody) positive women compared to women with negative TPO Ab. The recent ATA (American Thyroid Association) guidelines recommend that pregnant women with TSH (Thyroid Stimulating Hormone) concentration above 2.5mU/L should be evaluated for TPOAb status and LT4(levothyroxine) treatment should be considered with TSH values between 2.5mU/L and 4.0mU/L only when TPOAb status is positive.: All the pregnant women booked in first trimester underwent testing for TSH levels and subsequently for anti TPO Ab if TSH levels were between 2.5-4 mIU/ml. The hospital based prevalence of women with anti TPO Ab positive status was determined. These pregnancies were followed till term and the maternal and foetal complications associated with TPO Ab positive and negative status were compared. Total of 400 pregnant women were included. The hospital prevalence of women with anti TPO antibodies in first trimester of pregnancy with TSH values between 2.5- 4 mIU/ml was found to be 23.5%. Anti TPO antibody positive status was significantly more associated with antenatal complications especially GDM and IUGR as compared to patients with anti TPO antibody negative status (47.8% v/s 23.2%, p value 0.001).: Women with TPO Ab positive status are to be vigilantly monitored for early detection and management of various antenatal complications. Determining anti TPO Ab status helps in avoiding unnecessary treatment of the women with TPO Ab negative status and TSH between 2.5-4mIU/ml.

Low thyroid-stimulating hormone and its persistence beyond the first trimester of pregnancy

2018 ◽  
Vol 142 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Merav Fraenkel ◽  
Tali Shafat ◽  
Avivit Cahn ◽  
Offer Erez ◽  
Victor Novack ◽  
...  
Keyword(s):  
First Trimester ◽  
Thyroid Stimulating Hormone ◽  
First Trimester Of Pregnancy ◽  
Stimulating Hormone
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