| Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. | |
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MedLine Citation:
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PMID: 20534758 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Roberto Negro; Alan Schwartz; Riccardo Gismondi; Andrea Tinelli; Tiziana Mangieri; Alex Stagnaro-Green |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2010-06-09 |
Journal Detail:
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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:
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Created Date: 2010-09-08 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
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Languages: eng Pagination: E44-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Endocrinology, V. Fazzi Hospital, 73100 Lecce, Italy. dr.negro@libero.it. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Spontaneous
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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:
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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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