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Periconceptional changes in thyroid function: a longitudinal study
BACKGROUND: Limitations in our current knowledge of normative physiologic changes in thyroid function during the periconception window narrow our ability to establish an optimal approach to screening and diagnosis of thyroid disease in pregnant women. The objective of this study was to characterize...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337801/ https://www.ncbi.nlm.nih.gov/pubmed/22436200 http://dx.doi.org/10.1186/1477-7827-10-20 |
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author | Balthazar, Ursula Steiner, Anne Z |
author_facet | Balthazar, Ursula Steiner, Anne Z |
author_sort | Balthazar, Ursula |
collection | PubMed |
description | BACKGROUND: Limitations in our current knowledge of normative physiologic changes in thyroid function during the periconception window narrow our ability to establish an optimal approach to screening and diagnosis of thyroid disease in pregnant women. The objective of this study was to characterize changes in thyroid function during the transition from the pre-pregnant to pregnant state in normal fertile women. METHODS: Women (N = 60) ages 30-42 years without a history of thyroid disease, who were planning pregnancy, were observed prospectively before and during early pregnancy. Thyroid function (thyroid stimulating hormone, TSH and free thyroxine, FT4) was measured before conception and between 6 and 9 weeks gestation. Pre-pregnancy samples were analyzed for thyroid antibodies. Bivariate analyses and longitudinal curves (general estimating equation models) were used to analyze changes in thyroid function during the periconception window by antibody status. RESULTS: Pre-pregnancy TSH values were significantly higher than early pregnancy TSH (p < 0.001), but FT4 values did not differ (p = 0.53). TSH declined as gestational age increased (P < 0.01). Thyroid antibody positive women had a higher pre-pregnancy TSH compared to antibody negative women (p < 0.01). Periconceptional change in thyroid function was more variable among women with antibodies (p < 0.001). 50% of women with elevated pre-pregnancy TSH values (TSH > 3.0 mIU/L) had normal TSH values (TSH < 2.5 mIU/L) in pregnancy. CONCLUSIONS: TSH values decline during the transition from pre-pregnancy to early pregnancy. The change in TSH appears to be less predictable in women with thyroid antibodies. Periconceptional changes in thyroid function should be considered in formulating prenatal thyroid screening guidelines. |
format | Online Article Text |
id | pubmed-3337801 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-33378012012-04-27 Periconceptional changes in thyroid function: a longitudinal study Balthazar, Ursula Steiner, Anne Z Reprod Biol Endocrinol Research BACKGROUND: Limitations in our current knowledge of normative physiologic changes in thyroid function during the periconception window narrow our ability to establish an optimal approach to screening and diagnosis of thyroid disease in pregnant women. The objective of this study was to characterize changes in thyroid function during the transition from the pre-pregnant to pregnant state in normal fertile women. METHODS: Women (N = 60) ages 30-42 years without a history of thyroid disease, who were planning pregnancy, were observed prospectively before and during early pregnancy. Thyroid function (thyroid stimulating hormone, TSH and free thyroxine, FT4) was measured before conception and between 6 and 9 weeks gestation. Pre-pregnancy samples were analyzed for thyroid antibodies. Bivariate analyses and longitudinal curves (general estimating equation models) were used to analyze changes in thyroid function during the periconception window by antibody status. RESULTS: Pre-pregnancy TSH values were significantly higher than early pregnancy TSH (p < 0.001), but FT4 values did not differ (p = 0.53). TSH declined as gestational age increased (P < 0.01). Thyroid antibody positive women had a higher pre-pregnancy TSH compared to antibody negative women (p < 0.01). Periconceptional change in thyroid function was more variable among women with antibodies (p < 0.001). 50% of women with elevated pre-pregnancy TSH values (TSH > 3.0 mIU/L) had normal TSH values (TSH < 2.5 mIU/L) in pregnancy. CONCLUSIONS: TSH values decline during the transition from pre-pregnancy to early pregnancy. The change in TSH appears to be less predictable in women with thyroid antibodies. Periconceptional changes in thyroid function should be considered in formulating prenatal thyroid screening guidelines. BioMed Central 2012-03-21 /pmc/articles/PMC3337801/ /pubmed/22436200 http://dx.doi.org/10.1186/1477-7827-10-20 Text en Copyright ©2012 Balthazar and Steiner; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Balthazar, Ursula Steiner, Anne Z Periconceptional changes in thyroid function: a longitudinal study |
title | Periconceptional changes in thyroid function: a longitudinal study |
title_full | Periconceptional changes in thyroid function: a longitudinal study |
title_fullStr | Periconceptional changes in thyroid function: a longitudinal study |
title_full_unstemmed | Periconceptional changes in thyroid function: a longitudinal study |
title_short | Periconceptional changes in thyroid function: a longitudinal study |
title_sort | periconceptional changes in thyroid function: a longitudinal study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337801/ https://www.ncbi.nlm.nih.gov/pubmed/22436200 http://dx.doi.org/10.1186/1477-7827-10-20 |
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