Diagnosis and Management of Hypothyroidism in Pregnancy

Mooney, Claire J.; James, Diane; Kessenich, Cathy R.

doi:10.1111/j.1552-6909.1998.tb02661.x

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Mutations in the glucokinase gene of the fetus (28), maternal malnutrition such as low vitamin C intake (40), and abnormal placental function (47,54,56) have been shown to be associated with reduced birth weight. Furthermore, altered hormone action such as increased fetal exposure to glucocorticoids (53), maternal hypothyroidism (44), and maternal insulinlike growth factor I (12) is associated with altered birth weight. Therefore, individuals in the epidemiological studies may have low birth weight due to many different factors.…”

Section: A Long-term Effect Of Maternal Dietary Protein Restriction Omentioning

confidence: 99%

Differential hepatic lobar gene expression in offspring exposed to altered maternal dietary protein intake

Zhang

Byrne

2000

American Journal of Physiology-Gastrointestinal and Liver Physi

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Increased plasma fibrinogen concentrations are a recognized risk factor for coronary heart disease, and increased fibrinogen levels in adults are associated with parameters of reduced early growth. We studied fibrinogen gene expression in adult offspring of dams fed either a 20% (control) or an 8% protein diet [maternal low-protein (MLP) rats] during pregnancy and lactation and determined whether any effects were consistent between left and right liver lobes, since the fetal liver has a unique blood supply that produces differential stimuli to the left and right lobes. In MLP offspring, there was a reduction in all three fibrinogen mRNA copy numbers in the left liver lobe [left vs. right lobes for alpha-, beta-, and gamma-fibrinogen (x10(6) copies/ng total RNA): 8.04 vs. 23.16, P<0.001; 4.74 vs. 13.07, P<0.001; and 4.61 vs. 16.38, P = 0.007, respectively], with a parallel reduction in fibrinogen concentration in the left liver lobe (8.53+/-0.33 vs. 10.41 +/-0.65 arbitrary units, P = 0.014, left and right lobes, respectively). No such effect was observed in offspring of control dams. To investigate the underlying mechanism, glucocorticoid receptor function and mRNA levels were studied, since expression of fibrinogen genes is regulated by glucocorticoid hormones. The binding affinity of the high-affinity glucocorticoid receptor was reduced only in the left liver lobe of the MLP offspring (P = 0.02, left. vs. right), with a parallel reduction in this lobe in glucocorticoid receptor mRNA level (P = 0.006, left vs. right). In conclusion, maternal dietary protein restriction reduces fibrinogen gene expression, fibrinogen protein, and mRNA level and binding affinity of glucocorticoid receptors only in the left liver lobe of the adult offspring.

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Section: A Long-term Effect Of Maternal Dietary Protein Restriction Omentioning

confidence: 99%

Differential hepatic lobar gene expression in offspring exposed to altered maternal dietary protein intake

Zhang

Byrne

2000

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…3 Additional elements for the rubric were gleaned from articles to address issues regarding thyroid hormone replacement and drug interactions. [6][7][8][9][10] These practice guidelines, along with other published literature, served to provide a structure for curricular planning and evaluation.…”

Section: Data Collectionmentioning

confidence: 99%

Curricular Evaluation Using Clinical Practice Guidelines: A Hypothyroidism Exemplar

Plaza¹,

Lofgren²,

Draugalis³

2004

Am J Pharm Educ

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Objective. The purpose of this study was to demonstrate a methodology for the incorporation of clinical practice guidelines into therapeutics modules as a form of curricular planning, assessment, and evaluation. Methods. This proposed methodology was demonstrated using a hypothyroidism module. Clinical practice guidelines were used as a way to provide structure, as well as to prepare students to meet the current standard of care. Using a rubric constructed from course objectives in conjunction with clinical practice guidelines, the curricular content of the module was evaluated. The main outcome measure was performance on a hypothyroidism case study. Results. The hypothyroidism module did not meet all expectations for student performance when compared with course objectives and practice guidelines. Conclusion. This proposed methodology could be used with a variety of disease states in curricular planning and revision efforts.

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Maternal-Fetal Glucocorticoid Milieu Programs Hypothalamic-Pituitary-Thyroid Function of Adult Offspring

Slone-Wilcoxon

Redei

2004

Endocrinology

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To assess the role of maternal glucocorticoid milieu on the hypothalamic-pituitary-thyroid function of the offspring, we adrenalectomized (ADX) pregnant dams on gestation d 8 and implanted a placebo pellet or a continuous release 50- or 75-mg corticosterone (CORT) pellet. Maternal ADX led to realignment of the balance between maternal and fetal plasma CORT levels, resulting in an increase in CORT of fetal origin in the maternal compartment. Maternal ADX and low levels of CORT replacement had no discernable effect on maternal pituitary-thyroid measures. In contrast, the increase in fetal CORT, as a consequence of the absence of maternal glucocorticoids, decreased birth weight in neonates, decreased adult hypothalamic TRH mRNA levels, and increased plasma TSH levels in both male and female adult offspring, all of which were reversed by administration of basal levels of CORT to the pregnant ADX dam. Decreased plasma T3 concentrations in female offspring were reversed by administration of the higher levels of CORT to the ADX dams. Our data indicate that maternal glucocorticoids modulate the developing hypothalamic-pituitary-thyroid axis.

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Diagnosis and Management of Hypothyroidism in Pregnancy

Cited by 3 publications

References 18 publications

Differential hepatic lobar gene expression in offspring exposed to altered maternal dietary protein intake

Differential hepatic lobar gene expression in offspring exposed to altered maternal dietary protein intake

Curricular Evaluation Using Clinical Practice Guidelines: A Hypothyroidism Exemplar

Maternal-Fetal Glucocorticoid Milieu Programs Hypothalamic-Pituitary-Thyroid Function of Adult Offspring

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