Document Detail


To treat or not to treat euthyroid autoimmune disorder during pregnancy?
MedLine Citation:
PMID:  19092255     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Subclinical autoimmune hypothyroidism during pregnancy is associated with an increased risk of miscarriage and has a deleterious effect on fetal development. The aim of this study was to evaluate a screening and treatment strategy of subclinical hypothyroidism, and to establish normal ranges of thyroid-stimulating hormone (TSH) and thyroxine (T(4)) during pregnancy. METHODS: A retrospective study was carried out on 784 consecutive files of pregnant women; the files were systematically searched for thyroid function and antithyroid antibodies in order to determine the effect and the prevalence of anti-thyroid peroxidase antibodies (TPO-Ab) during pregnancy, and to evaluate treatment with levothyroxin (LT(4)) in TPO-Ab carriers. RESULTS: Among the 75 TPO-Ab-positive patients, 42 received LT(4) treatment during pregnancy. Although the range of TSH serum levels was wide, the mean TSH level was significantly higher in TPO-Ab-positive women (3 vs. 1 mIU/l, p < 0.01). No significant difference in the obstetrical complications rate was observed between TPO-Ab-positive and TPO-Ab-negative populations. CONCLUSIONS: Our study provides information on normal ranges of serum TSH and free T(4) for Belgian pregnant women receiving iodide supplementation. Based on our results, we suggest supplementation of TPO-Ab-positive pregnant women with 50 microg/day of LT(4), unless their TSH levels are lower than 1 mIU/l, to avoid the risk of hypothyroidism during pregnancy.
Authors:
F Debiève; S Dulière; P Bernard; C Hubinont; P De Nayer; C Daumerie
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Publication Detail:
Type:  Journal Article     Date:  2008-12-18
Journal Detail:
Title:  Gynecologic and obstetric investigation     Volume:  67     ISSN:  1423-002X     ISO Abbreviation:  Gynecol. Obstet. Invest.     Publication Date:  2009  
Date Detail:
Created Date:  2009-04-17     Completed Date:  2009-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7900587     Medline TA:  Gynecol Obstet Invest     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  178-82     Citation Subset:  IM    
Copyright Information:
Copyright 2008 S. Karger AG, Basel.
Affiliation:
Department of Obstetrics, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium. debieve@obst.ucl.ac.be
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MeSH Terms
Descriptor/Qualifier:
Autoantibodies / blood
Autoimmune Diseases / blood,  diagnosis*,  drug therapy,  immunology
Female
Humans
Hypothyroidism / blood,  diagnosis*,  drug therapy,  immunology
Iodide Peroxidase / immunology
Pregnancy
Pregnancy Complications / drug therapy,  immunology*
Retrospective Studies
Thyrotropin / blood*
Thyroxine / blood,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Autoantibodies; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin; EC 1.11.1.8/Iodide Peroxidase

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