Maternal First Trimester TSH Concentrations: Do They Affect Perinatal and Endocrine Outcomes?

M. Fraenkel; T. Shafat; O. Erez; Y. Lichtenstein; J. Awesat; V. Novack; A. Tsur

doi:10.1055/s-0042-107350

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2016; 48(07): 427-432
DOI: 10.1055/s-0042-107350

Endocrine Care

Maternal First Trimester TSH Concentrations: Do They Affect Perinatal and Endocrine Outcomes?

Authors

M. Fraenkel

¹Endocrine Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
T. Shafat

²Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel

³Clinical Research Center, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
O. Erez

²Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel

⁴Department of Obstetrics & Gynecology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
Y. Lichtenstein

²Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel

³Clinical Research Center, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
J. Awesat

²Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel

³Clinical Research Center, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
V. Novack

²Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel

³Clinical Research Center, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
A. Tsur

⁵Endorine and Diabetes Clinic, Clalit Health Services, Jerusalem, Israel

Abstract

We aimed to examine the distribution of 1^st trimester TSH and evaluate its association with perinatal outcomes and future development of maternal thyrotoxicosis. This retrospective cohort study included data of all women without prior thyroid disease who delivered a singleton at our medical center from 1/2001 to 12/2011 and had a 1^st trimester TSH<4.0 mU/l. Women were divided according to 1^st trimester TSH concentrations into quartiles and by predefined TSH values (mU/l): 1) TSH<0.1; 2) TSH 0.11–0.2; 3) TSH 0.21–0.4; and 4) TSH 0.4–4. Obstetrical outcomes, hCG concentrations, and future thyroid status were collected from electronic medical records. A total of 13 841 women fulfilled the inclusion criteria. Mean maternal TSH concentration at 5 weeks of gestation was 2.09±0.83 mU/l and decreased to 1.29±0.87 mU/l in weeks 8–9 with an increase towards the end of the 1^st trimester. Odds ratio for future thyrotoxicosis was 3.64 in the lowest compared to the highest TSH quartile and 10.03 in those with TSH<0.1 compared to TSH 0.41–4 mU/l. Rates of female fetuses were higher in the low TSH quartiles and in the lower TSH groups, however baby gender was not associated with increased risk of future thyrotoxicosis. Low maternal 1^st trimester TSH quartiles or concentrations were not associated with adverse pregnancy outcome. Only a minor fraction of pregnant women with a low first tirmester TSH subsequently developed future thyrotoxicosis.

Key words

pregnancy - thyroid function - thyrotoxicosis - pregnancy outcomes

Full Text

References

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