Document Detail


Fetal free thyroxine concentrations in pregnant women with autoimmune thyroid disease.
MedLine Citation:
PMID:  22948761     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Fetuses from mothers with autoimmune thyroid disease (AITD) may be affected by antithyroid antibodies, antithyroid drugs, and iodine.
OBJECTIVE: The study correlated fetal free T(4) (fT4) with fetal ultrasound parameters and maternal thyroid function, thyroid antibodies, and medication dose from mothers with AITD.
DESIGN AND SETTING: The study was designed as a prospective cohort study and conducted in an academic referral center.
PATIENTS: Eighty-three of 85 women with AITD completed the study; 38 were treated for hyperthyroidism and 25 for hypothyroidism, and 20 were euthyroid.
MAIN OUTCOME MEASURES: Outcomes were as follows: 1) fetal-fT4, TSH, ultrasound parameters (morphology, biometrics, heart rate); and 2) maternal-fT4, TSH, antithyroid drug dose, and antithyroid antibodies, thyroid peroxidase and TSH receptor (TRAK). Parameters were determined at the same time, between the 22nd and 33rd wk gestation.
RESULTS: A total of 48.3% of fetuses from hyperthyroid mothers, 60% of fetuses from hypothyroid mothers, and 10% of fetuses from euthyroid mothers had elevated fT4 levels (P = 0.006). In hypothyroid mothers, the presence of both thyroid antibodies was related to fetal hyperthyroidism, whereas absence was related to fetal euthyroidism (P = 0.019). Hyperthyroid mothers (TRAK-positive, thyroid peroxidase-negative) with hyperthyroid fetuses had significantly higher mean TRAK than hyperthyroid mothers with euthyroid fetuses (13.7 vs. 3.7 IU/liter; P = 0.02). Fetal fT4 correlated weakly negatively with maternal TSH within the normal range, but not with ultrasound parameters or with antithyroid drug dose.
CONCLUSION: High fetal fT4 levels were unexpectedly frequent in women with AITD, including maternal autoimmune hypo- and hyperthyroidism. Further studies are needed, as well as noninvasive methods to assess fetal thyroid function.
Authors:
Svetlana Spremovic-Radjenovic; Aleksandra Gudovic; Gordana Lazovic; Jelena Marinkovic; Nebojsa Radunovic; Aleksandar Ljubic
Publication Detail:
Type:  Journal Article     Date:  2012-09-04
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  97     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-06     Completed Date:  2013-01-25     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4014-21     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Autoimmune Diseases / blood,  drug therapy*
Female
Fetal Blood*
Humans
Hyperthyroidism / blood,  drug therapy*
Hypothyroidism / blood,  drug therapy*
Pregnancy
Pregnancy Complications / blood,  drug therapy*,  immunology
Prospective Studies
Thyroid Function Tests
Thyrotropin / blood
Thyroxine / blood*
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
9002-71-5/Thyrotropin; Q51BO43MG4/Thyroxine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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