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Implications of High Free Thyroxine (FT4) Concentrations in Euthyroid Pregnancies: The FaSTER Trial.
MedLine Citation:
PMID:  24606107     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context: Lower birthweight has been reported in conjunction with high maternal free thyroxine (FT4) in euthyroid pregnancies, raising concerns for suboptimal outcomes. Objective: Explore relationships between high maternal FT4 and pregnancy complications in euthyroid women. Further examine relationships among maternal size, FT4 and birthweight. Design: Observational multicenter cohort study. Setting: Prenatal clinics. Study Subjects: 9209 euthyroid women with singleton pregnancies. Interventions: None. Main Outcome Measures: Relationships between second trimester high maternal FT4 and pregnancy/delivery complications, and among FT4, maternal weight and birthweight. Results: Women in the highest FT4 quintile are younger and weigh less than women in quintiles 1-4; gestational diabetes and preeclampsia occur less often (p = < 0.001, < 0.001, < 0.001, and 0.05, respectively). Lowest median birthweight occurs among women in the highest FT4 quintile (p = < 0.001), but deliveries < 37 weeks' gestation are not increased. Labor/delivery complications do not differ by FT4 quintile. Restricting analyses to maternal weight-adjusted small-for-gestational-age deliveries yields similar results, except for preeclampsia. In the highest maternal weight decile, adjusted median birthweight is 266g higher (8.3%) than in the lowest weight decile; adjusted median FT4 is 0.91 pmol/L lower (6.8%). Among women in the highest FT4 decile, adjusted median birthweight is 46g lower (1.3%) than in the lowest FT4 decile. All three relationships are statistically significant (p = < 0.001, < 0.001, and 0.004, respectively). Conclusions: Lower median birthweight among euthyroid women with high FT4 is not associated with adverse pregnancy outcomes. Further investigation is indicated to determine how variations in thyroid hormone concentration influence birthweight.
Authors:
James E Haddow; Wendy Y Craig; Louis M Neveux; Hamish R M Haddow; Glenn E Palomaki; Geralyn Lambert-Messerlian; Fergal D Malone; Mary E D'Alton;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-2-28
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-3-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  jc20141053     Citation Subset:  -    
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