Associations of Hypothyroxinemia With Risk of Preeclampsia–Eclampsia and Gestational Hypertension

Abstract

ObjectiveTo investigate the association between hypothyroxinemia and the risk of preeclampsia–eclampsia and gestational hypertension.DesignHistorical cohort study.MethodsThe study included pregnant individuals who delivered live-born singletons and had at least one thyroid function assessment during pregnancy at a tertiary hospital. Hypothyroxinemia was defined as thyroid-stimulating hormone (TSH) levels within the normal reference range and free thyroxine (FT4) levels lower than the tenth percentile. Risk ratios (RRs) with 95% confidence intervals (95% CIs) for preeclampsia–eclampsia and gestational hypertension between women with and without a diagnosis of hypothyroxinemia during pregnancy were estimated using a generalized estimating equation model.ResultsA total of 59,463 women with live-born singletons were included in the analysis. Logistic regression models with restricted cubic spline suggested that there was a U-shaped association between FT4 levels and preeclampsia–eclampsia risk. Compared with euthyroid women, those with hypothyroxinemia had an increased risk of preeclampsia–eclampsia (RR = 1.16, 95% CI: 1.02–1.31), and the risk increased with the increasing severity of hypothyroxinemia (p for trend < 0.001). Moreover, persistent hypothyroxinemia from the first to second trimesters was associated with an increased risk of preeclampsia–eclampsia (RR = 1.37, 95% CI: 1.03–1.83), especially for women with severe hypothyroxinemia (RR = 1.70, 95% CI: 1.12–2.58). In contrast, there was no association between hypothyroxinemia and gestational hypertension.ConclusionOur study suggested that hypothyroxinemia was only associated with an increased risk of preeclampsia–eclampsia, especially in women with persistent hypothyroxinemia in the first half of pregnancy. Analyses of the associated risk of gestational hypertension with hypothyroxinemia were not significant.

Diagnostic Value of IGFBP-2 in Predicting Preeclampsia before 20 Weeks of Pregnancy: A Prospective Nested Case-Control Study

“…Several studies speculated that during the formation of PE placenta, extravillous trophoblast (EVT) suffers from decreased invasiveness and extravillous uterine spiral artery remodeling obstacle, resulting in shallow placenta implantation and poor placental vascular formation. In placental implantation, plasma proteins have a specific role as placental factors that induce endothelial dysfunction and a variety of other pathophysiological alterations linked to PE [9][10][11]. Due to the complexity and multifactorial nature of the disease, we employed antibody microarray technology to identify the crucial predictive proteins linked to PE.…”

Emerging research themes in maternal hypothyroidism: a bibliometric exploration

“…Subclinical hypothyroidism is associated with a higher risk of preeclampsia ( 37 ), whereas isolated hypothyroidism or positive TPOAb shows no clear association with gestational hypertension or preeclampsia ( 11 ). Some studies suggest that the risk of preeclampsia-eclampsia in women with isolated hypothyroidism increases with the severity of hypothyroidism ( 85 ). Hypothyroidism also increases the risk of gestational diabetes ( 86 ).…”

Characteristics of changes in fetal doppler blood flow parameters in women with gestational hypertension at different stages of pregnancy

“…Гіпертензивні розлади вагітності, як-от гестаційна гіпертензія (ГГ) та прееклампсія, залишаються значною причиною материнської та плодової захворюваності і смертності в усьому світі [1][2][3][4][5][6]. Хоча точна патофізіологія цих розладів усе ще не до кінця зрозуміла, очевидно, що існують гемодинамічні шляхи, які відіграють вирішальну роль у їхньому розвитку [7][8][9].…”