Cord blood thyroid-stimulating hormone level in high-risk pregnancies

Chan, Louis Yik-Si; Chiu, Pui Yu; Lau, Tze Kin

doi:10.1016/s0301-2115(02)00418-9

Cited by 23 publications

(15 citation statements)

References 17 publications

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“…According to our study, there was no significant relationship between sex of the baby and CB TSH. This results correlates with the studies by Armanian et al, Kim et al (13) and Lee et al (17) and contradicts the study by Chan et al, (18) wherein the male babies had higher mean CB TSH value.…”

Section: Discussionsupporting

confidence: 78%

Maternal and Perinatal Factors Affecting Cord Blood Thyroid Stimulating Hormone Level

P¹,

Vazhayil²,

Balusamy³

2018

jemds

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BACKGROUND Incidence of Congenital Hypothyroidism in India is relatively high when compared to that of other parts of the world. The fact that only 5-10% can be diagnosed clinically signifies the role of screening program for early diagnosis and early initiation of therapy to treat this preventable cause of intellectual disability. Cord blood TSH (CB TSH) estimation has high sensitivity, but various maternal and perinatal factors affect the CB TSH levels, which may interfere with the interpretation. This study was done to find out the various maternal and perinatal factors affecting CB TSH level. MATERIALS AND METHODS A hospital-based cross-sectional study was conducted in the Department of Neonatology, Govt. Medical College, Ernakulam over a period of one year from February 2016 to January 2017. We enrolled 127 live neonates selected by systematic random sampling method. Cord blood TSH level was estimated and the results were statistically analysed with respect to various maternal and perinatal factors. RESULTS Mean CB TSH in the study population was 9.713 ± 7.286. The risk factors for a significantly high CB TSH level were low Apgar at 1 minute, Preterm babies and Primigravida mothers (p < 0.05). A significantly low CB TSH was noted in preterm neonates who received antenatal steroids (p < 0.05). The other factors like gestational diabetes, gestational hypertension, gender of the baby, birth weight and meconium stained liquor were found to have no significant relationship with the CB TSH level. CONCLUSION Mainly low Apgar at 1 min which is an indicator of foetal distress/ perinatal asphyxia, prematurity and parity contributed to the significant elevation of CB TSH level. Antenatal steroids can significantly blunt the TSH surge. Due consideration should be given to these factors while interpreting CB TSH levels.

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Section: Discussionsupporting

confidence: 78%

Maternal and Perinatal Factors Affecting Cord Blood Thyroid Stimulating Hormone Level

P¹,

Vazhayil²,

Balusamy³

2018

jemds

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“…We also observed an association between higher neonatal TSH levels in infants born to mothers with preeclampsia. Two studies found higher cord blood TSH in preterm neonates born to mothers with preeclampsia; however, other studies, some of which evaluated term infants, have not observed this finding (7, 12, 27, 28). Our findings, in combination with the other studies that found higher neonatal TSH levels in preterm infants born to mothers with preeclampsia, suggest that there may be placental insufficiency and/or fetal hypoxia which in turn triggers higher TSH levels in the neonate.…”

Section: Discussionmentioning

confidence: 95%

Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone

Ryckman

Spracklen

Dagle

et al. 2014

Journal of Pediatric Endocrinology and Metabolism

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Thyroid hormones are important regulators of fetal neurodevelopment. Among preterm infants, TSH is highly variable. Understanding this variability will further improvements in screening for thyroid disorders in preterm infants. We examined 61 maternal and infant clinical and demographic factors for associations with neonatal TSH levels in 698 preterm neonates. TSH was measured as part of routine State-mandated newborn screening in Iowa. Of the maternal characteristics, nulliparous women (P=8x10−4), women with preeclampsia (P=2x10−3), and those with induced labor (P=3x10−3) had infants with higher TSH levels. TSH levels at the time of newborn screening were associated with respiratory distress syndrome (RDS) (P<0.0001) and sepsis (P=3x10−3). We replicated findings between parity and preeclampsia previously observed in primarily term infants. We also observed strong relationships between neonatal TSH and complications of prematurity including RDS and sepsis, which has implications for future studies examining this relationship both prenatally and longitudinally after birth.

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“…Prior reports have indicated that complications of labor and delivery can alter thyroid hormone function in mothers and infants at the time of delivery (Chan et al 2001a, 2003). Several studies have demonstrated associations between mode of delivery and measures of stress-related hormones measured in maternal and umbilical cord blood (Gitau et al 2001; Mears et al 2004; Vogl et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Birth Delivery Mode Modifies the Associations between Prenatal Polychlorinated Biphenyl (PCB) and Polybrominated Diphenyl Ether (PBDE) and Neonatal Thyroid Hormone Levels

Herbstman

Sjödin

Apelberg

et al. 2008

Environ Health Perspect

189

106

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BackgroundDeveloping infants may be especially sensitive to hormone disruption from chemicals including polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs).ObjectiveWe investigated relationships between cord serum levels of PCBs and PBDEs and thyroid hormones measured in cord blood serum and neonatal blood spots.MethodsWe measured PCBs and PBDEs, thyrotropin (TSH), thyroxine (T4) and free T4 (FT4) in cord blood serum from 297 infants who were delivered at the Johns Hopkins Hospital in 2004–2005. We abstracted results of total T4 (TT4) measured in blood spots collected in the hospital and at neonatal visits. We used delivery mode (augmented vaginal deliveries and nonelective cesarean deliveries) as a surrogate for intrapartum stress, which is known to alter cord blood thyroid hormones.ResultsIn the full study population, no compounds were associated with a change in average TSH, FT4, or TT4. BDE-100 was associated with increased odds of low cord TT4, BDE-153 with increased odds of low cord TT4 and FT4, and no compounds were associated with increased odds of high TSH. For infants born by spontaneous, vaginal, unassisted deliveries, PCBs were associated with lower cord TT4 and FT4 and lower TT4 measured in neonatal blood spots. PBDEs showed consistent but mainly nonsignificant negative associations with TT4 and FT4 measurements.ConclusionsPrenatal PCB and PBDE exposures were associated with reduced TT4 and FT4 levels among infants born by spontaneous, unassisted vaginal delivery. Intrapartum stress associated with delivery mode may mask hormonal effects of PCBs and PBDEs.

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Cord blood thyroid-stimulating hormone level in high-risk pregnancies

Cited by 23 publications

References 17 publications

Maternal and Perinatal Factors Affecting Cord Blood Thyroid Stimulating Hormone Level

Maternal and Perinatal Factors Affecting Cord Blood Thyroid Stimulating Hormone Level

Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone

Birth Delivery Mode Modifies the Associations between Prenatal Polychlorinated Biphenyl (PCB) and Polybrominated Diphenyl Ether (PBDE) and Neonatal Thyroid Hormone Levels

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