scholarly journals Thyroxine Supplementation in Pregnant Women After Thyroidectomy for Thyroid Cancer and Neonatal Birth Weight

2021 ◽  
Vol 12 ◽  
Author(s):  
Zheng Ding ◽  
Fei Guo ◽  
Yulai Zhou ◽  
Xiaoyi Huang ◽  
Zhiwei Liu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Birth Weight ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Late Pregnancy ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Inverse Association ◽  
Neonatal Birth Weight ◽  
Maternal Thyroid

Patients are often supplemented with a sufficient dose of thyroxine after thyroidectomy for thyroid cancer. However, the influence of thyroxine supplementation on fetal growth in pregnant women after thyroidectomy for thyroid cancer remains unclear. The aim of this study was to investigate the effect of thyroxine supplementation on neonatal birth weight. This cohort study included 49,896 pregnant women (278 patients with a history of thyroidectomy for thyroid cancer and 39,363 control cases after exclusion). Thyroid parameters were examined in pregnant women and their newborns. The associations between maternal thyroid function and neonatal birth weight and small for gestational age were studied using regression analyses. In the levothyroxine supplementation group, free thyroxine (FT4) levels were significantly higher in both early pregnancy (P < 0.001) and late pregnancy (P < 0.001) groups than in the control group. Furthermore, levels of neonatal thyroid stimulating hormone (P = 0.032) and birth weight (P = 0.043) were significantly lower than those in the control group. We also observed a significant inverse association between maternal FT4 levels in early pregnancy and neonatal birth weight (P=0.028), especially in male newborns (P=0.036). In summary, after thyroidectomy for thyroid cancer, a sufficient dose of thyroxine supplementation in early pregnancy is significantly associated with reduced birth weight and may need to be monitored.

Changes in baroreceptor sensitivity for heart rate during normotensive pregnancy and the puerperium

2000 ◽  
Vol 98 (3) ◽  
pp. 259-268 ◽  
Author(s):  
Melanie J. BLAKE ◽  
Allison MARTIN ◽  
Brad N. MANKTELOW ◽  
Charles ARMSTRONG ◽  
Aidan W. HALLIGAN ◽  
...  
Keyword(s):  
Heart Rate ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
High Frequency ◽  
Post Partum ◽  
Late Pregnancy ◽  
Late Gestation ◽  
Control Group ◽  
Pulse Interval ◽  
Normotensive Pregnancy

Normal pregnancy is associated with marked changes in cardiovascular haemodynamics, which in part may be due to changes in autonomic control mechanisms. Baroreflex sensitivity for heart rate (BRS) was calculated in the supine and standing positions using power spectral analysis of pulse interval (PI) and systolic blood pressure (SBP) in 16 normotensive pregnant women and 10 normotensive non-pregnant controls. The pregnant women were studied on three occasions during their pregnancy (early, mid- and late gestation) and once during the puerperium. Supine total SBP variability increased between early and late pregnancy by 79% [95% confidence intervals (CI) 30%, 145%; P < 0.001], and supine high-frequency PI variability decreased by 75% (CI 51%, 88%; P < 0.001). Supine BRS fell by 50% (P < 0.001), with values returning to early-pregnancy levels in the puerperium, which were similar to those recorded in the control group. Standing SBP variability and BRS values were unchanged during pregnancy and post partum. The low/high frequency ratio of PI variability, taken as a surrogate measure of sympathovagal balance, increased by 137% (CI 42%, 296%; P < 0.01) in the supine but not the standing position from early to late pregnancy. This was due to a decrease in high-frequency variability rather than to an increase in low-frequency variability, suggesting that these changes may have been due to vagal withdrawal rather than increased sympathetic activity. Normotensive pregnancy is associated with a marked decrease in supine BRS, although the exact mechanisms for these changes remain unclear. Further studies are required to define whether changes in BRS and sympathovagal tone in early pregnancy can be used to predict the onset of pregnancy-induced hypertension.

Establishment of Early Pregnancy Related Thyroid Hormone Models and Reference Intervals for Pregnant Women in China Based on Real World Data

2021 ◽  
Vol 53 (04) ◽  
pp. 272-279
Author(s):  
Chaochao Ma ◽  
Xiaoqi Li ◽  
Lixin Liu ◽  
Xinqi Cheng ◽  
Fang Xue ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Dynamic Change ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Stimulating Hormone

AbstractThyroid hormone reference intervals are crucial for diagnosing and monitoring thyroid dysfunction during early pregnancy, and the dynamic change trend of thyroid hormones during pregnancy can assist clinicians to assess the thyroid function of pregnant women. This study aims to establish early pregnancy related thyroid hormones models and reference intervals for pregnant women. We established two derived databases: derived database* and derived database#. Reference individuals in database* were used to establish gestational age-specific reference intervals for thyroid hormones and early pregnancy related thyroid hormones models for pregnant women. Individuals in database# were apparently healthy non-pregnant women. The thyroid hormones levels of individuals in database# were compared with that of individuals in database* using nonparametric methods and the comparative confidence interval method. The differences in thyroid stimulating hormone and free thyroxine between early pregnant and non-pregnant women were statistically significant (p<0.0001). The reference intervals of thyroid stimulating hormone, free thyroxine and free triiodothyronine for early pregnant women were 0.052–3.393 μIU/ml, 1.01–1.54 ng/dl, and 2.51–3.66 pg/ml, respectively. Results concerning thyroid stimulating hormone and free thyroxine reference intervals of early pregnancy are comparable with those from other studies using the same detection platform. Early pregnancy related thyroid hormones models showed various change patterns with gestational age for thyroid hormones. Early pregnancy related thyroid hormones models and reference intervals for pregnant women were established, so as to provide accurate and reliable reference basis for the diagnosing and monitoring of maternal thyroid disfunction in early pregnancy.

miR-27b-3p is highly expressed in serum of patients with preeclampsia and has clinical significance

2021 ◽  
Vol 21 ◽  
Author(s):  
Yang Yang ◽  
Fang Tang ◽  
Xuezhi Zhao
Keyword(s):  
Blood Pressure ◽  
Birth Weight ◽  
Serum Creatinine ◽  
Pregnant Women ◽  
Clinical Significance ◽  
Roc Curve ◽  
Late Pregnancy ◽  
Healthy Controls ◽  
Urine Protein ◽  
Fetal Birth Weight

Background: Preeclampsia (PE) is defined as a salient complication of late pregnancy. microRNAs (miRNAs) have emerged as critical biological regulators in PE. This study determined miR-27b-3p expression in serum of PE patients and investigated its clinical significance in PE. Methods: Totally 130 pregnant women including 90 PE patients (51 mild PE and 39 severe PE) and 40 healthy controls were enrolled in this study. miR-27b-3p expression in the serum of PE patients and healthy controls was detected using RT-qPCR. The correlation among miR-27b-3p expression and 24-h urine protein, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine, and fetal birth weight was analyzed using Pearson's correlation coefficient. The targeting relationship between miR-27b-3p and PPARG was verified. PPARG protein level in PE patients was detected using ELISA kits. The predictive efficiency of miR-27b-3p and PPARG in PE was analyzed using the receiver operating characteristic (ROC) curve. Results: Compared to normal pregnant women, PE pregnant women, especially severe PE patients had higher miR-27b-3p expression. miR-27b-3p was positively correlated with 24-h urine protein, SBP, DBP, and serum creatinine, but negatively correlated with fetal birth weight. PPARG was poorly expressed in PE patients and negatively correlated with miR-27b-3p. ROC curve showed that both miR-27b-3p and PPARG had good predictive efficacy on PE. Conclusion: miR-27b-3p expression in serum of pregnant women with PE was positively correlated with the severity of PE symptoms, suggesting the involvement of miR-27b-3p in PE occurrence.

scholarly journals Comparison of Maternal and Perinatal Outcome in Pregnant Women with Hypothyroidism Diagnosed before Conception with Hypothyroidism Diagnosed during Pregnancy

2014 ◽  
Vol 2 (2) ◽  
pp. 21-27
Author(s):  
P Basnet ◽  
N Aggrawal ◽  
V Suri ◽  
P Dutta ◽  
K Mukhopadhyay
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Perinatal Outcome ◽  
Fetal Outcome ◽  
Endocrine Disorder ◽  
Fetal Birth Weight ◽  
Group A ◽  
Group B

BACKGROUND: Thyroid disorder is one of commonest endocrine disorder in women and hence constitutes a common endocrine disorder complicating pregnancy. Diagnosing and treating hypothyroidism preconceptionally and during early pregnancy appears to be a useful strategy to improve maternal and fetal outcome. OBJECTIVE: To compare the maternal and perinatal outcome in pregnant women with hypothyroidism diagnosed preconceptionally with hypothyroidism diagnosed during pregnancy. METHODS: A prospective study. One hundred pregnant women with hypothyroidism at less than 20 weeks Period of Gestation (POG) were recruited for the study and grouped into two groups: Group A-hypothyroidism diagnosed and on treatment before conception, Group B-hypothyroidism diagnosed and started on treatment during pregnancy. Both groups were intensively monitored during pregnancy with serial Thyroid Function Test (TFT) and thyroxine replacement doses were adjusted accordingly. Various maternal, perinatal and fetal outcome measures were studied in both groups prospectively till delivery. RESULTS: The maternal and fetal complications were comparable in the two groups, however the fetal birth weight was significantly higher in Group A versus Group B (2.89±0.485kg vs. 2.70±0.453kg; p=0.039). All the new born babies had normal thyroid function. CONCLUSION: Hypothyroidism diagnosed preconceptionally or during early pregnancy and treated appropriately has beneficial effect on fetal birth weight, and hence the total pregnancy outcome. Screening for thyroid dysfunction should be judiciously performed in all high risk women prior to a planned conception or during their first antenatal visit. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11170   Journal of Universal College of Medical Sciences (2014) Vol.2(2): 21-27

scholarly journals Exposure to Perflouroalkyl acids and foetal and maternal thyroid status: a review

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sophie A. H. Boesen ◽  
Manhai Long ◽  
Maria Wielsøe ◽  
Vicente Mustieles ◽  
Mariana F. Fernandez ◽  
...  
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Inverse Association ◽  
Postnatal Exposure ◽  
Free Triiodothyronine ◽  
Perfluorodecanoic Acid ◽  
Pubmed Database ◽  
Thyroid Disruption ◽  
Total Thyroxine ◽  
Maternal Thyroid ◽  
Perfluorinated Alkyl Acids

Abstract Background Exposure to perfluorinated-alkyl-acids (PFAAs) is ubiquitous. PFAAs are hormone-disrupting compounds that are strongly suspected to affect mother-child-health such as fetal growth. Thyroid disruption is a plausible mechanism of action. We aim to summarize the epidemiological evidence for the relation between prenatal and postnatal exposure to PFAAs and disruption of thyroid homeostasis in mothers and/or infants. Method Fifteen original publications on PFAAs concentrations and thyroid hormones (TH) in pregnant women and/or infants were found upon a literature search in the PubMed database. Information on exposure to seven PFAAs congeners [Perfluorooctane sulfonate (PFOS), Perfluorooctanoate (PFOA), Perfluorohexane sulfonate (PFHxS), Perfluorononanoic acid (PFNA), Perfluorodecanoic acid (PFDA), Perfluoroundecanoic acid (PFUnA), and Perfluorododecanoic acid (PFDoA)] and thyroid stimulating hormone (TSH), free and total thyroxine (FT4 and TT4), free and total triiodothyronine (FT3 and TT3), T3RU (Free triiodothyronine resin uptake) and FT4-index (FT4I) levels were recorded. We evaluated sampling of maternal TH by trimester, and infant TH by sex stratification. Reported associations between mother or infant PFAAs and TH were not uniformly assessed in the selected studies. Results Ten out of the fifteen studies examined maternal PFAAs concentration and TSH level. Seven studies showed significant associations between TSH and exposure to six PFAAs congeners, most of them were positive. Maternal T4 and T3 were investigated in nine studies and five studies found inverse associations between exposure to six PFAAs congeners and TH (TT3, TT4, FT3, FT4 and FT4I) levels. Eight of the fifteen studies investigated PFAAs concentrations and infant TSH. Infant TSH level was significantly affected in four studies, positively in three studies. Nine studies investigated infant T4 and T3 and seven studies found significant associations with PFAAs exposure. However, both inverse and positive significant associations with infant TH were found eliciting no clear direction. Conclusion Results indicate a mainly positive relationship between maternal PFAAs concentrations and TSH levels, and suggestion of an inverse association with T4 and/or T3 levels. Associations of infant TH with PFAAs concentration were less consistent.

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 Prenatal multivitamin supplementation increases birth weight

2017 ◽  
Vol 6 (6) ◽  
pp. 2148
Author(s):  
Müberra Namli Kalem ◽  
Zeynep Kamalak ◽  
Nermin Kosus ◽  
Aydin Kosus ◽  
Ziya Kalem
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Iron Supplementation ◽  
Positive Impact ◽  
Maternal Diet ◽  
Vitamin Supplementation ◽  
Control Group ◽  
Iron Group ◽  
Multivitamin Supplementation ◽  
Iron Supplements

Background: The aim of this study is to examine whether there is any positive impact of prenatal iron and vitamin supplementation on birth weight, and if this practice could be a cause of macrosomia.Methods: A total of 1,838 term pregnant women were included in this study and were divided into four groups: iron group (women having only iron supplementation), vitamin (women using only multivitamins), vitamin+iron (women using both iron and multivitamin preparations), and control group (women having neither iron nor vitamin supplements). Statistical analysis was performed to compare age, gravida, parity, hemoglobin, BMI and birth weight. Groups were compared in terms of macrosomia and correlation analysis carried out between demographics and birth weight.Results: The birth weight was significantly higher in the vitamin group and the vitamin+iron group than in the iron group and the control group. Vitamin supplementation increased the risk of macrosomia 3.9 times, while vitamin+iron usage increased the risk 4.8 times.Conclusions: Uncontrolled use of multivitamins and/or iron supplements may increase tendency for fetal macrosomia. The use of multivitamins and/or iron supplements by pregnant women must take into account maternal age, maternal diet and maternal BMI. Our findings support a reduction in the unnecessary use of vitamin and iron supplements in pregnancy, and a reversal of the trend to start vitamin and iron supplementation without any control. The increasing prevalence of obesity and excessive weight in pregnant women should be a warning against the uncontrolled usage of vitamins and iron during pregnancy.

Maternal Body Mass Index (BMI) and Mid-Upper Arm Circumference (MUAC) in Early Pregnancy as Predictors of Low Birth Weight Infants

2018 ◽  
Vol 24 (8) ◽  
pp. 6203-6205
Author(s):  
Yoga Dwi Oktavianda ◽  
Syahru Ramadhan ◽  
Thalia Mufida ◽  
Ummul Mukminin ◽  
Rima Irwinda
Keyword(s):  
Body Mass Index ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Upper Arm ◽  
Maternal Nutritional Status ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Low birth weight is one of the determinants of infant mortality, morbidity, and disability, which can even have an impact on the future. Several studies have suggested that the condition of low birth weight (LBW) infants is influenced by the lack of maternal nutritional status in early pregnancy. Moreover, the prevalence of malnutrition in Indonesia is still high. Therefore, this study attempted to analyze the relationship of maternal nutritional status in early pregnancy as a predictor of LBW infants. Using a cross-sectional study design, this study involved 62 pregnant patients aged 20–35 years who had antenatal visits and a term delivery at Puskesmas Kecamatan Cakung. The measurements of body mass index (BMI) and mid-upper arm circumference (MUAC) in early pregnancy are used to determine the maternal nutritional status. Pregnant women with BMI <18.5 or MUAC <23.5 cm are considered to have less nutritional status. Meanwhile, LBW infants are defined as babies with birth weight <2500 grams. This study proves that the risk of birth of LBW infants is increased in pregnant women with BMI <18.5 (underweight) (OR 5.37) and less MUAC (OR 20.4).

Clinical Value of Ultrasound Fetal Neck Transparent Layer Index in Early Screening of 21-Trisomy Syndrome

2020 ◽  
Vol 10 (4) ◽  
pp. 961-966
Author(s):  
Weibo Fan ◽  
Shuli Zeng ◽  
Qiang Zhang
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Control Group ◽  
Ultrasound Screening ◽  
Analysis Method ◽  
Inclusion Criteria ◽  
Clinical Value ◽  
Early Screening ◽  
Transparent Layer ◽  
Experimental Group

This study used a retrospective analysis method to select 1061 pregnant women from March 2012 to December 2018 to our hospital for obstetrics, and 11–11 weeks +6 days of ultrasound screening for NT values, according to inclusion criteria and exclusion. There were 60 patients who met the criteria of the experimental group and 313 who met the criteria of the control group. All of them were subjected to fetal villus puncture in early pregnancy or amniocentesis in middle pregnancy. The specimens were divided into two parts, one was cultured through cells and the chromosomes were prepared. Analysis and send a copy to a collaborative laboratory for highthroughput sequencing of chromosomes. The aim was to investigate the association between simple cervical thickening (NT) thickening and karyotype and chromosomal microdeletion/microreplication in 11–13 weeks +6 days of gestation. The results of this study show that NT thickening is associated with karyotypic abnormalities, especially with 21-trisomy syndrome; when karyotype is normal, NT thickening is associated with chromosome microdeletions/microduplication; only a single NT increase when thick, the meaning of CNVs detection is not significant.

scholarly journals Early Maternal Thyroid Function During Gestation Is Associated With Fetal Growth, Particularly in Male Newborns

2017 ◽  
Vol 102 (3) ◽  
pp. 1059-1066 ◽  
Author(s):  
Tanja G. M. Vrijkotte ◽  
E. Jessica Hrudey ◽  
Marcel B. Twickler
Keyword(s):  
Birth Weight ◽  
Thyroid Function ◽  
Fetal Growth ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Subclinical Hypothyroidism ◽  
Growth Patterns ◽  
Fetal Sex ◽  
Intrauterine Growth ◽  
Maternal Thyroid

Abstract Background: Intrauterine growth patterns are influenced by maternal thyroid function during gestation and by fetal sex. It is unknown, however, whether the relationships between maternal thyrotropin (TSH) and free thyroxine (fT4) levels in early pregnancy and fetal growth outcomes are modified by fetal sex. Design: Data were obtained from a community-based cohort study of pregnant women living in Amsterdam (Amsterdam Born Children and Their Development study). TSH and fT4 levels were determined during the first prenatal screening at median 13 weeks (interquartile range, 12 to 14). Women with live-born singletons and no overt thyroid dysfunction were included (N = 3988). Associations between these maternal hormones and birth weight, small for gestational age (SGA), and large for gestational age (LGA) were analyzed separately for each sex. Results: After adjustments, 1 pmol/L increase in maternal fT4 levels was associated with a reduction in birth weight of 33.7 g (P &lt; 0.001) in male newborns and 16.1 g (P &lt; 0.05) in female newborns. Increased maternal fT4 was not associated with increased odds for SGA, but was associated with a decreased odds for LGA in boys [per 1 pmol/L; odds ratio (OR), 0.79; 95% confidence interval (CI), 0.69 to 0.90]. Maternal subclinical hypothyroidism in early pregnancy (TSH &gt; 2.5 mU/L, 7.3%) was associated with increased odds for LGA in male newborns (OR, 1.95; 95% CI, 1.22 to 3.11). Conclusion: Maternal fT4 in early pregnancy was observed to be inversely associated with birth weight, with a stronger relationship in males. Male infants also had increased odds for LGA in mothers with subclinical hypothyroidism. Sexual dimorphism appears to be present in the relationship between maternal thyroid metabolism and fetal intrauterine growth, with stronger associations in male infants.

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