Document Detail


Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy.
MedLine Citation:
PMID:  20534758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: The definition of what constitutes a normal TSH during pregnancy is in flux. Recent studies suggested that the first trimester upper limit of normal for TSH should be 2.5 mIU/liter. OBJECTIVE: The objective of the study was to evaluate the pregnancy loss and preterm delivery rate in first-trimester thyroid peroxidase antibody-negative women with TSH values between 2.5 and 5.0 mIU/liter. DESIGN: The present study is a component of a recently published large-scale prospective trial that evaluated the impact of levothyroxine treatment on maternal and neonatal complications in thyroid peroxidase-positive women with TSH levels above 2.5 mIU/liter. The present study evaluated 4123 thyroid peroxidase antibody-negative women with TSH levels at or below 5.0 mIU/liter. Women were divided into two groups based on their initial TSH: group A, TSH level below 2.5 mIU/liter, excluding hyperthyroid women defined as an undetectable TSH with an elevated free T(4), and group B, TSH level between 2.5 and 5.0 mIU/liter. SETTING: The study was conducted at two ambulatory clinics of community hospitals in southern Italy. PATIENTS: A total of 4123 women were evaluated. INTERVENTION: There was no intervention. MAIN OUTCOME MEASURES: The incidence of pregnancy loss and preterm delivery in group A as compared with group B was measured. RESULTS: The rate of pregnancy loss was significantly higher in group B as compared with group A (6.1 vs. 3.6% respectively, P = 0.006). There was no difference in the rate of preterm delivery between the two groups. CONCLUSIONS: The increased incidence of pregnancy loss in pregnant women with TSH levels between 2.5 and 5.0 mIU/liter provides strong physiological evidence to support redefining the TSH upper limit of normal in the first trimester to 2.5 mIU/liter.
Authors:
Roberto Negro; Alan Schwartz; Riccardo Gismondi; Andrea Tinelli; Tiziana Mangieri; Alex Stagnaro-Green
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-06-09
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  95     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-08     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E44-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Endocrinology, V. Fazzi Hospital, 73100 Lecce, Italy. dr.negro@libero.it.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / blood,  epidemiology,  etiology,  immunology
Adult
Case-Control Studies
Embryo Loss / blood,  epidemiology*,  etiology,  immunology
Female
Humans
Immunoglobulins, Thyroid-Stimulating / blood*
Incidence
Osmolar Concentration
Parity / physiology
Pregnancy
Pregnancy Trimester, First / blood*,  immunology
Reference Values
Thyrotropin / analysis,  blood*
Young Adult
Chemical
Reg. No./Substance:
0/Immunoglobulins, Thyroid-Stimulating; 9002-71-5/Thyrotropin

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


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