Marta Hernández1,2, Carolina López1,2, Berta Soldevila3,4,5,6, Laura Cecenarro3,7, María Martínez-Barahona4,8, Elisabet Palomera4,9, Ferran Rius1,2, Albert Lecube1,2,6, Maria José Pelegay10, Jordi García11, Dídac Mauricio3,4,5,6, Manel Puig Domingo3,4,5,6. 1. Endocrinology and Nutrition Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain. 2. Institut de Recerca Biomèdica de Lleida (IRB Lleida), Universitat de Lleida, Lleida, Spain. 3. Endocrinology and Nutrition Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. 4. Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Campus can Ruti, Universitat Autònoma de Barcelona, Badalona, Spain. 5. CIBER de enfermedades raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain. 6. CIBER de diabetes y enfermedades metabólicas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain. 7. Endocrinology and Nutrition Department, Hospital Privado Universitario de Córdoba, Córdoba, Argentina. 8. Paedriatics Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. 9. Unitat de Recerca, Hospital de Mataró, Mataró, Spain. 10. Gynecology and Obstetrics Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain. 11. Paedriatics Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
Abstract
OBJECTIVE: An association of pregnancy outcomes with subclinical hypothyroidism has been reported; however, there still exists a strong controversy regarding whether subclinical hypothyroidism ought to be dealt with or not. The objective of the study was to evaluate the association of foetal-maternal complications with first trimester maternal Thyrotropin (TSH) values. DESIGN: A retrospective study in a single tertiary care hospital was performed. PATIENTS: A total of 1981 pregnant women were studied during 2012. MEASUREMENTS: Thyrotropin (TSH) universal screening was performed between 9 and 12 weeks of gestation. Outcomes included foetal-maternal complications and newborn health parameters. RESULTS: Median TSH was 1.72 (0.99-2.61) mIU/L. The incidence of perinatal loss, miscarriage and stillbirth was 7.2%, 5.9% and 1.1%, respectively. Median TSH of women with and without miscarriage was 1.97 (1.29-3.28) vs 1.71 (0.96-2.58) mIU/L (P = .009). Incidence of pre-eclampsia was 3.2%; TSH in these women was 2.10 (1.40-2.74) vs 1.71 (0.98-2.59) mIU/L in those without (P = .027). TSH in women with dystocia in labour was 1.76 (1.00-2.53) vs 1.68 (0.94-2.59) mIU/L in those who gave birth with normal progression (P = .044). Women with TSH 2.5-5.1 mIU/L had a higher risk of perinatal loss [OR 1.589 (1.085-2.329)], miscarriage [OR 1.702 (1.126-2.572)] and premature birth [OR 1.39 (1.013-1.876)], adjusted by mother's age. There was no association with the other outcomes analysed. CONCLUSIONS: There is a positive association between maternal TSH in the first trimester of pregnancy and the incidence of perinatal loss and miscarriage. The TSH cut-off value of 2.5 mIU/L identified women with higher adverse pregnancy outcomes.
OBJECTIVE: An association of pregnancy outcomes with subclinical hypothyroidism has been reported; however, there still exists a strong controversy regarding whether subclinical hypothyroidism ought to be dealt with or not. The objective of the study was to evaluate the association of foetal-maternal complications with first trimester maternal Thyrotropin (TSH) values. DESIGN: A retrospective study in a single tertiary care hospital was performed. PATIENTS: A total of 1981 pregnant women were studied during 2012. MEASUREMENTS: Thyrotropin (TSH) universal screening was performed between 9 and 12 weeks of gestation. Outcomes included foetal-maternal complications and newborn health parameters. RESULTS: Median TSH was 1.72 (0.99-2.61) mIU/L. The incidence of perinatal loss, miscarriage and stillbirth was 7.2%, 5.9% and 1.1%, respectively. Median TSH of women with and without miscarriage was 1.97 (1.29-3.28) vs 1.71 (0.96-2.58) mIU/L (P = .009). Incidence of pre-eclampsia was 3.2%; TSH in these women was 2.10 (1.40-2.74) vs 1.71 (0.98-2.59) mIU/L in those without (P = .027). TSH in women with dystocia in labour was 1.76 (1.00-2.53) vs 1.68 (0.94-2.59) mIU/L in those who gave birth with normal progression (P = .044). Women with TSH 2.5-5.1 mIU/L had a higher risk of perinatal loss [OR 1.589 (1.085-2.329)], miscarriage [OR 1.702 (1.126-2.572)] and premature birth [OR 1.39 (1.013-1.876)], adjusted by mother's age. There was no association with the other outcomes analysed. CONCLUSIONS: There is a positive association between maternal TSH in the first trimester of pregnancy and the incidence of perinatal loss and miscarriage. The TSH cut-off value of 2.5 mIU/L identified women with higher adverse pregnancy outcomes.
Authors: Isabelle Runkle; María Paz de Miguel; Ana Barabash; Martin Cuesta; Ángel Diaz; Alejandra Duran; Cristina Familiar; Nuria García de la Torre; Miguel Ángel Herraiz; Nuria Izquierdo; Ángel Diaz; Clara Marcuello; Pilar Matia; Verónica Melero; Carmen Montañez; Inmaculada Moraga; Natalia Perez-Ferre; Noelia Perez; Carla Assaf-Balut; Miguel Ángel Rubio; Jorge Gabriel Ruiz-Sanchez; Concepción Sanabria; María José Torrejon; Johanna Valerio; Laura Del Valle; Alfonso Calle-Pascual Journal: Front Endocrinol (Lausanne) Date: 2021-10-19 Impact factor: 5.555
Authors: Małgorzata Karbownik-Lewińska; Jan Stępniak; Anna Żurawska; Andrzej Lewiński Journal: Int J Environ Res Public Health Date: 2020-03-23 Impact factor: 3.390