scholarly journals Maternal Thyroid Function during the Second Half of Pregnancy and Child Neurodevelopment at 6, 12, 24, and 60 Months of Age

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Jonathan Chevrier ◽  
Kim G. Harley ◽  
Katherine Kogut ◽  
Nina Holland ◽  
Caroline Johnson ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Equilibrium Dialysis ◽  
Convincing Evidence ◽  
Free T4 ◽  
Impaired Child ◽  
Motor Functioning ◽  
Child Neurodevelopment ◽  
Maternal Thyroid ◽  
And Behavior

Although evidence suggests that maternal hypothyroidism and mild hypothyroxinemia during the first half of pregnancy alters fetal neurodevelopment among euthyroid offspring, little data are available from later in gestation. In this study, we measured free T4 using direct equilibrium dialysis, as well as total T4 and TSH in 287 pregnant women at 27 weeks' gestation. We also assessed cognition, memory, language, motor functioning, and behavior in their children at 6, 12, 24, and 60 months of age. Increasing maternal TSH was related to better performance on tests of cognition and language at 12 months but not at later ages. At 60 months, there was inconsistent evidence that higher TSH was related to improved attention. We found no convincing evidence that maternal TH during the second half of pregnancy was related to impaired child neurodevelopment.

scholarly journals A Novel Nomogram for Predicting the Risk of Premature Delivery Based on the Thyroid Function in Pregnant Women

2022 ◽  
Vol 12 ◽  
Author(s):  
Yu Meng ◽  
Jing Lin ◽  
Jianxia Fan
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Thyroid Function ◽  
Premature Delivery ◽  
Multivariable Logistic Regression Analysis ◽  
Decision Curve Analysis ◽  
Cutoff Values ◽  
Lemeshow Test ◽  
Maternal Thyroid

BackgroundMaternal thyroid dysfunction and autoantibodies were associated with preterm delivery. However, recommendations for cutoff values of thyroperoxidase antibody (TPOAb) positivity and thyroid-stimulating homone (TSH) associated with premature delivery are lacking.ObjectiveTo identify the pregnancy-specific cutoff values for TPOAb positivity and TSH associated with preterm delivery. To develop a nomogram for the risk prediction of premature delivery based on maternal thyroid function in singleton pregnant women without pre-pregnancy complications.MethodsThis study included data from the International Peace Maternity and Child Care Health Hospital (IPMCH) in Shanghai, China, between January 2013 and December 2016. Added data between September 2019 and November 2019 as the test cohort. Youden’s index calculated the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration. Univariate and multivariable logistic regression analysis were used to screen the risk factors of premature delivery. The nomogram was developed according to the regression coefficient of relevant variables. Discrimination and calibration of the model were assessed using the C-index, Hosmer-Lemeshow test, calibration curve and decision curve analysis.Results45,467 pregnant women were divided into the training and validation cohorts according to the ratio of 7: 3. The testing cohort included 727 participants. The pregnancy-specific cutoff values associated with the risk of premature delivery during the first trimester were 5.14 IU/mL for TPOAb positivity and 1.33 mU/L for TSH concentration. Multivariable logistic regression analysis showed that maternal age, history of premature delivery, elevated TSH concentration and TPOAb positivity in the early pregnancy, preeclampsia and gestational diabetes mellitus were risk factors of premature delivery. The C-index was 0.62 of the nomogram. Hosmer-Lemeshow test showed that the Chi-square value was 2.64 (P = 0.955 > 0.05). Decision curve analysis showed a positive net benefit. The calibration curves of three cohorts were shown to be in good agreement.ConclusionsWe identified the pregnancy-specific cutoff values for TPOAb positivity and TSH concentration associated with preterm delivery in singleton pregnant women without pre-pregnancy complications. We developed a nomogram to predict the occurrence of premature delivery based on thyroid function and other risk factors as a clinical decision-making tool.

scholarly journals Familial Dysalbuminaemic Hyperthyroxinaemia and Other Causes of Euthyroid Hyperthyroxinaemia

1987 ◽  
Vol 80 (12) ◽  
pp. 750-752 ◽  
Author(s):  
C Farror ◽  
M L Wellby ◽  
C Beng
Keyword(s):  
Thyroid Function ◽  
Equilibrium Dialysis ◽  
Elevated Serum ◽  
Normal Serum ◽  
Thyroid Function Tests ◽  
Free T4 ◽  
Incorrect Diagnosis ◽  
Biochemical Studies ◽  
Autosomal Dominance ◽  
Clinical Awareness

Clinical and biochemical studies on a family in which 3 members have familial dysalbuminaemic hyperthyroxinaemia (FDH) are presented. They were clinically euthyroid with elevated serum thyroxine (T4) and free T4 indices but normal free T4 by equilibrium dialysis and normal serum triiodothyronine (total and free). All thyroid function tests on the remaining family members were normal. The inheritance is consistent with autosomal dominance. Also presented are data on 4 unrelated patients with FDH and two patients with T4 autoantibodies. The methods for detecting FDH, T4 antibodies and other causes of euthyroid hyperthyroxinaemia are now freely available. Since these anomalies may be more common than previously supposed, clinical awareness of the conditions is necessary to protect patients from the consequences of incorrect diagnosis of thyrotoxicosis.

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 The Risk of Preeclampsia According to High Thyroid Function in Pregnancy Differs by hCG Concentration

2016 ◽  
Vol 101 (12) ◽  
pp. 5037-5043 ◽  
Author(s):  
Tim I. M. Korevaar ◽  
Eric A. P. Steegers ◽  
Layal Chaker ◽  
Marco Medici ◽  
Vincent W. V. Jaddoe ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Outcome Measure ◽  
High Body Mass Index ◽  
Population Based ◽  
Additional Measurement ◽  
Free T4 ◽  
Normal Thyroid Function ◽  
General Community ◽  
Risk Of Preeclampsia

Context: During pregnancy, there is an increased demand for thyroid hormone. The pregnancy hormone human chorionic gonadotropin (hCG) is an important physiological stimulator of thyroid function. Already high-normal maternal free T4 concentrations are associated with a higher risk of preeclampsia. Objective: The objective of the investigation was to study our hypothesis that hCG concentrations can distinguish a physiological form of high thyroid function from a more pathological form of high thyroid function and that the risk of preeclampsia would differ accordingly. Design: TSH, free T4, hCG, or thyroperoxidase antibody concentrations were determined in pregnant women participating in a population-based prospective cohort study. Setting: The study was conducted in the general community. Participants: A nonselected sample of 5146 pregnant women participated in the study. Interventions: There were no interventions. Main Outcome Measure(s): Preeclampsia was measured. Results: Women with high hCG-associated high thyroid function did not have a higher risk of preeclampsia than women with normal thyroid function. In contrast, women with low hCG and high thyroid function had a 3.4- to 11.1-fold higher risk of preeclampsia. These risk estimates were amplified in women with a high body mass index. Women with a low hCG and suppressed TSH (<0.10 mU/L) had a 3.2- to 8.9-fold higher risk of preeclampsia. hCG was not associated with preeclampsia, and results remained similar after exclusion of thyroperoxidase antibody-positive women. Conclusion: This study suggests that, in contrast to women with a high hCG associated high thyroid function, women with low hCG and high thyroid function during pregnancy are at a higher risk of developing preeclampsia. The additional measurement of hCG may therefore help to distinguish a more pathological form of high thyroid function and women at a high risk of preeclampsia.

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 Perchlorate and Thiocyanate Exposure and Thyroid Function in First-Trimester Pregnant Women

2010 ◽  
Vol 95 (7) ◽  
pp. 3207-3215 ◽  
Author(s):  
Elizabeth N. Pearce ◽  
John H. Lazarus ◽  
Peter P. A. Smyth ◽  
Xuemei He ◽  
Daniela Dall'Amico ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Sodium Iodide ◽  
Urinary Iodine ◽  
First Trimester ◽  
Iodine Intake ◽  
Sodium Iodide Symporter ◽  
Free T4 ◽  
Cross Sectional ◽  
Serum Tsh

Context: Thyroid hormone, requiring adequate maternal iodine intake, is critical for fetal neurodevelopment. Perchlorate decreases thyroidal iodine uptake by competitively inhibiting the sodium/iodide symporter. It is unclear whether environmental perchlorate exposure adversely affects thyroid function in pregnant women. Thiocyanate, derived from foods and cigarette smoke, is a less potent competitive sodium/iodide symporter inhibitor than perchlorate. Objective: Our objective was to determine whether environmental perchlorate and/or thiocyanate exposure is associated with alterations in thyroid function in pregnancy. Design and Setting: We conducted a cross-sectional study at health centers in Cardiff, Wales, and Turin, Italy. Patients: During 2002–2006, 22,000 women at less than 16 wk gestation were enrolled in the Controlled Antenatal Thyroid Screening Study. Subsets of 261 hypothyroid/hypothyroxinemic and 526 euthyroid women from Turin and 374 hypothyroid/hypothyroxinemic and 480 euthyroid women from Cardiff were selected based on availability of stored urine samples and thyroid function data. Main Outcome Measures: Urinary iodine, thiocyanate, and perchlorate and serum TSH, free T4 (FT4), and thyroperoxidase antibody were measured. Results: Urinary iodine was low: median 98 μg/liter in Cardiff and 52 μg/liter in Turin. Urine perchlorate was detectable in all women. The median (range) urinary perchlorate concentration was 5 μg/liter (0.04–168 μg/liter) in Turin and 2 μg/liter (0.02–368 μg/liter) in Cardiff. There were no associations between urine perchlorate concentrations and serum TSH or FT4 in the individual euthyroid or hypothyroid/hypothyroxinemic cohorts. In multivariable linear analyses, log perchlorate was not a predictor of serum FT4 or TSH. Conclusions: Low-level perchlorate exposure is ubiquitous but did not affect thyroid function in this cohort of iodine-deficient pregnant women.

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.

scholarly journals Correlation between Sonographic Findings of Maternal Thyroid Gland and Thyroid Function Tests during Pregnancy

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Maimoona Rasool ◽  
Sarah Maryam ◽  
M. Sohail Anjum Noor ◽  
Mehreen Fatima ◽  
Sultan Ayaz ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Great Influence ◽  
Thyroid Volume ◽  
Study Data ◽  
Thyroid Function Tests ◽  
Hormonal Changes ◽  
Function Tests ◽  
Maternal Thyroid

Background: Pregnancy has great influence on maternal thyroid gland. It induces significant physiological as well as hormonal changes that alters the maternal thyroid function. Our goal was to determine this pregnancy associated changes in thyroid gland. Objective: To correlate the sonographic findings of maternal thyroid gland with thyroid function tests during pregnancy. Material and methods: 135 pregnant women were recruited in this study, data of TSH, T3 and T4 was obtained and correlated it with the sonographic findings of maternal thyroid gland in each trimester of pregnancy. Results: In the 135 sampled pregnant women, mean thyroid gland volume was 4.08±1.19 cm3. The mean levels of T3, T4 and TSH were v3.37±.44 pmol/L, 14.96±2.49 pmol/L and 1.21±.92 mIU/L respectively. A remarkable correlation between thyroid hormones and thyroid volume was observed. Conclusion: It is concluded that the ultra-sonographic findings is correlated with the thyroid function tests during pregnancy.

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 Iodine Prophylaxis Using Iodized Salt and Risk of Maternal Thyroid Failure in Conditions of Mild Iodine Deficiency

2008 ◽  
Vol 93 (7) ◽  
pp. 2616-2621 ◽  
Author(s):  
Mariacarla Moleti ◽  
Vincenzo Pio Lo Presti ◽  
Maria Cristina Campolo ◽  
Filiberto Mattina ◽  
Marina Galletti ◽  
...  
Keyword(s):  
Relative Risk ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Iodized Salt ◽  
Short Term ◽  
Iodine Prophylaxis ◽  
Salt Consumption ◽  
Maternal Thyroid ◽  
Iodized Salt Consumption

Abstract Context: Mild to moderate iodine deficiency during pregnancy can cause transient maternal hypothyroidism and impaired mental development of the progeny. These unfavorable effects are preventable by iodine supplementation. In Europe, however, less than 50% pregnant women receive iodine-containing supplements, thus representing dietary iodized salt the only carrier of iodine for most women in this life stage. Objective/Design: This longitudinal study is aimed to investigate the effects of long-term iodized salt consumption on maternal thyroid function during gestation. Participants/Outcome Measures: We prospectively evaluated thyroid function in 100 consecutive thyroperoxidase antibody-negative pregnant women from a mildly iodine-deficient area. Sixty-two women who had regularly used iodized salt for at least 2 yr prior to becoming pregnant and 38 who commenced iodized salt consumption upon becoming pregnant were classified as long-term (LT) and short-term (ST) iodine supplemented, respectively. Results: Long-term iodized salt consumption resulted in a very low prevalence of maternal thyroid failure (MTF) in LT women. Conversely, short-term iodine prophylaxis does not seem to protect against the risk of MTF, the prevalence of which was almost 6-fold higher in ST than LT women (36.8% vs. 6.4%; χ2 14.7, P < 0.0005; relative risk 5.7, 95% confidence interval 2.03–16.08, P < 0.001). The relative risk reduction amounted to 82.5%, this measure indicating the extent to which long-term iodine prophylaxis using iodized salt would reduce the risk of MTF in ST women. Conclusions: Prolonged iodized salt significantly improves maternal thyroid economy and reduces the risk of maternal thyroid insufficiency during gestation, probably because of a nearly restoring intrathyroidal iodine stores.

Sign in / Sign up

Export Citation Format

Share Document