OBJECTIVE: To estimate the possibility of long-term effects of subclinical thyroid dysfunction on hypertension and other cardiovascular-related conditions during pregnancy. METHODS: This is a secondary analysis of a prospective prenatal population-based study in which serum thyroid-function analytes were measured from November 2000 through April 2003. Women with evidence of overt thyroid disease were excluded. The remaining women were classified as being euthyroid, having subclinical hyperthyroid, or having subclinical hypothyroid, and the frequency of pregnancy-associated hypertensive disorders was compared between these groups. RESULTS: Pregnancy outcomes in 24,883 women were analyzed for pregnancy hypertension, classified as gestational hypertension, mild preeclampsia, or severe preeclampsia. The incidence of hypertensive disorders were compared between the three cohorts. The overall incidences of hypertension in pregnancy were 6.2%, 8.5%, and 10.9% in the subclinical hyperthyroid, euthyroid, and subclinical hypothyroid groups, respectively, and were found to be significant when unadjusted (P=.016). After adjusting for confounding factors, there was a significant association between subclinical hypothyroidism and severe preeclampsia (adjusted odds ratio 1.6, 95% confidence interval 1.1-2.4; P=.03). CONCLUSION: Women with subclinical hypothyroidism identified during pregnancy have an increased risk for severe preeclampsia when compared with euthyroid women. LEVEL OF EVIDENCE: II.
OBJECTIVE: To estimate the possibility of long-term effects of subclinical thyroid dysfunction on hypertension and other cardiovascular-related conditions during pregnancy. METHODS: This is a secondary analysis of a prospective prenatal population-based study in which serum thyroid-function analytes were measured from November 2000 through April 2003. Women with evidence of overt thyroid disease were excluded. The remaining women were classified as being euthyroid, having subclinical hyperthyroid, or having subclinical hypothyroid, and the frequency of pregnancy-associated hypertensive disorders was compared between these groups. RESULTS: Pregnancy outcomes in 24,883 women were analyzed for pregnancy hypertension, classified as gestational hypertension, mild preeclampsia, or severe preeclampsia. The incidence of hypertensive disorders were compared between the three cohorts. The overall incidences of hypertension in pregnancy were 6.2%, 8.5%, and 10.9% in the subclinical hyperthyroid, euthyroid, and subclinical hypothyroid groups, respectively, and were found to be significant when unadjusted (P=.016). After adjusting for confounding factors, there was a significant association between subclinical hypothyroidism and severe preeclampsia (adjusted odds ratio 1.6, 95% confidence interval 1.1-2.4; P=.03). CONCLUSION:Women with subclinical hypothyroidism identified during pregnancy have an increased risk for severe preeclampsia when compared with euthyroid women. LEVEL OF EVIDENCE: II.
Authors: Torie C Plowden; Enrique F Schisterman; Lindsey A Sjaarda; Neil J Perkins; Robert Silver; Rose Radin; Keewan Kim; Noya Galai; Alan H DeCherney; Sunni L Mumford Journal: Am J Obstet Gynecol Date: 2017-09-14 Impact factor: 8.661
Authors: Brian M Casey; Elizabeth A Thom; Alan M Peaceman; Michael W Varner; Yoram Sorokin; Deborah G Hirtz; Uma M Reddy; Ronald J Wapner; John M Thorp; George Saade; Alan T N Tita; Dwight J Rouse; Baha Sibai; Jay D Iams; Brian M Mercer; Jorge Tolosa; Steve N Caritis; J Peter VanDorsten Journal: N Engl J Med Date: 2017-03-02 Impact factor: 91.245
Authors: Spyridoula Maraka; Naykky M Singh Ospina; Derek T O'Keeffe; Rene Rodriguez-Gutierrez; Ana E Espinosa De Ycaza; Chung-Il Wi; Young J Juhn; Charles C Coddington; Victor M Montori; Marius N Stan Journal: Thyroid Date: 2016-05-16 Impact factor: 6.568