Document Detail


Maternal thyroid function at 11 to 13 weeks of gestation and subsequent fetal death.
MedLine Citation:
PMID:  20718684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies have shown that overt hypothyroidism is associated with a substantial risk of miscarriage. There is controversy as to whether subclinical hypothyroidism has the same effect and whether such effect is mediated by the presence of antithyroid antibodies. Our hypothesis is that maternal thyroid function in the first trimester is altered in pregnancies ending in miscarriage or fetal death.
METHODS: Thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine, anti-thyroperoxidase antibody, and anti-thyroglobulin antibody at 11-13 weeks of gestation were measured in 202 singleton pregnancies that subsequently resulted in miscarriage or fetal death, and the values were compared with the results of 4318 normal pregnancies.
RESULTS: In the fetal loss group, compared to the unaffected group, there was an increase in median TSH multiple of the normal median (1.133 vs. 1.007 MoM), decrease in median FT4 MoM (0.958 vs. 0.992 MoM), and increase in the incidence of TSH above the 97.5th centile (5.9% vs. 2.5%) and FT4 below the 2.5th centile (5.0% vs. 2.5%). Logistic regression analysis demonstrated that in the prediction of fetal loss there were significant contributions from FT4 MoM, maternal black ethnic origin, history of chronic hypertension, and use of ovulation drugs. The prevalence of antithyroid antibody positivity was not significantly different in the fetal loss group compared to that of normal pregnancies (15.3% vs. 16.8%).
CONCLUSIONS: Impaired thyroid function may predispose to miscarriage and fetal death.
Authors:
Ghalia Ashoor; Nerea Maiz; Micheal Rotas; Firas Jawdat; Kypros H Nicolaides
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  20     ISSN:  1557-9077     ISO Abbreviation:  Thyroid     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-09     Completed Date:  2011-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  989-93     Citation Subset:  IM    
Affiliation:
Harris Birthright Research Centre, King's College Hospital, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / blood*,  epidemiology,  etiology
Adult
Autoantibodies / blood
Female
Fetal Death / blood*,  epidemiology,  etiology
Humans
Hypertension / epidemiology
Hypothyroidism / blood*,  complications,  epidemiology
Iodide Peroxidase / immunology
Pregnancy
Pregnancy Trimester, First / blood*
Prospective Studies
Thyrotropin / blood
Thyroxine / blood
Triiodothyronine / blood
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/anti-thyroglobulin; 6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin; EC 1.11.1.8/Iodide Peroxidase

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


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