Thyrotoxicosis of pregnancy

Labadzhyan, Artak; Brent, Gregory A.; Hershman, Jerome M.; Leung, Angela M.

doi:10.1016/j.jcte.2014.07.008

Cited by 23 publications

(20 citation statements)

References 62 publications

(87 reference statements)

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“…During the first trimester, a surge of human chorionic gonadotropin hCG), which contains the same α subunit as TSH and can stimulate the thyroidal TSH receptor, results in an increase in thyroid hormone and a subsequent decrease in serum TSH concentrations . Transient gestational thyrotoxicosis, mediated by hCG, is the most common cause of thyrotoxicosis in pregnancy . Autoimmune hyperthyroidism from Graves’ disease is the second most frequent cause of thyrotoxicosis in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

“…31 Transient gestational thyrotoxicosis, mediated by hCG, is the most common cause of thyrotoxicosis in pregnancy. 32 Autoimmune hyperthyroidism from Graves' disease is the second most frequent cause of thyrotoxicosis in pregnant women. At the population level, increases in dietary iodine intake are associated with a higher prevalence of thyroid autoimmunity.…”

Section: Discussionmentioning

confidence: 99%

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Serum iodine concentration in pregnant women and its association with urinary iodine concentration and thyroid function

Pan

Cui

Chen

et al. 2019

Clinical Endocrinology

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Summary Objective This study aims to evaluate the association of serum iodine concentration (SIC) with urinary iodine concentration (UIC) and thyroid function in pregnant women, as well as to provide the reference range of SIC of pregnant women in iodine‐sufficiency area. Methods Pregnant women were enrolled in the Department of Obstetrics, Tanggu Maternity Hospital, Tianjin from March 2016 to May 2017. Fasting venous blood and spot urine samples were collected. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid‐stimulating hormone (TSH), thyroglobulin (Tg), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), UIC and SIC were measured. Results One thousand and ninety‐nine participants were included in this study. The median UIC was 156 μg/L. The median SIC was 108 μg/L, and the 95% reference interval for SIC was 65.6‐164.7 μg/L. SIC was positively correlated with UIC (r = 0.12, P < 0.001), FT3 (r = 0.23, P < 0.001), and FT4 (r = 0.50, P < 0.001) and was inversely correlated with TSH (r = −0.14, P < 0.001). Pregnant women with a SIC < 79.9 μg/L had a higher risk of hypothyroxinemia compared to those with higher SIC (OR = 2.44, 95% CI: 1.31‐4.75). Those having SIC > 138.5 μg/L were more likely to have thyrotoxicosis than those with lower SIC values (OR = 13.52, 95% CI: 4.21‐43.36). Conclusions Serum iodine level is associated with UIC and thyroid function in pregnant women. Low SIC was associated with increased risk for iodine deficiency and hypothyroxinemia, while high SIC was related to excess and thyrotoxicosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Serum iodine concentration in pregnant women and its association with urinary iodine concentration and thyroid function

Pan

Cui

Chen

et al. 2019

Clinical Endocrinology

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“…TPOAb may be present in either case. Thyroid ultrasound may show enlarged gland dimensions and typical increased blood flow in Graves’ disease, but there are no absolute differentiating features from gestational thyrotoxicosis [65] ; hence it is not usually essential. Radioisotope scanning is contraindicated in pregnancy.…”

Section: Hyperthyroidismmentioning

confidence: 99%

Benign thyroid disease in pregnancy: A state of the art review

Tingi

Syed

Kyriacou

et al. 2016

Journal of Clinical & Translational Endocrinology

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“…If the free T4 levels remains within the normal range this is referred to as subclinical and if above reference range this is termed overt hyperthyroidism. 67 …”

Section: Thyroid Disorders In Pregnancymentioning

confidence: 99%

Thyroid disorders in subfertility and early pregnancy

Anandappa

Joshi

Polański

et al. 2020

Therapeutic Advances in Endocrinology

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Disorders of thyroid function are common in pregnancy and have implications for foetal and maternal health. Thyroid autoimmunity, as evidenced by the presence of elevated levels of anti-thyroid antibodies (anti-TPO and anti-Tg antibodies) is associated with an increased risk of miscarriage, though the mechanism remains poorly understood. There has been considerable focus on the implications and optimal management of pregnant women with thyroid disease, especially those undergoing assisted reproduction. Pregnancy results in significant changes in thyroid physiology and these need to be understood by clinicians involved in the care of pregnant women. Guidelines for the use of thyroxine and target thyroid function tests have been produced by international bodies but it is recognised that these predominantly reflect expert opinion rather than established evidence-based practice. Importantly a number of key clinical trials have been performed to aid understanding, particularly of the consequences of hypothyroidism for mother and baby, and the effectiveness of thyroid hormone use in autoimmune and subclinical hypothyroidism. This review summarises the current knowledge base and guidance for practice relating to thyroid disorders in pregnancy and subfertility.

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Thyrotoxicosis of pregnancy

Cited by 23 publications

References 62 publications

Serum iodine concentration in pregnant women and its association with urinary iodine concentration and thyroid function

Serum iodine concentration in pregnant women and its association with urinary iodine concentration and thyroid function

Benign thyroid disease in pregnancy: A state of the art review

Thyroid disorders in subfertility and early pregnancy

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