The Impact of Thyroid Disorders on Clinical Pregnancy Outcomes in a Real-World Study Setting

Sitoris, Georgiana; Veltri, Flora; Kleynen, Pierre; Cogan, Alexandra; Belhomme, Julie; Rozenberg, Serge; Pepersack, Thierry; Poppe, Kris

doi:10.1089/thy.2019.0199

Cited by 22 publications

(18 citation statements)

References 46 publications

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“…In this study, there was no significant difference in the incidence of GDM, spontaneous abortion, PROM, fetal distress, low birth weight, or fetal macrosomia between the two groups. Our results are consistent with the results of several studies [21,41,42]. However, some studies have found an association between TAI and other poor pregnancy and fetal outcomes.…”

Section: Discussionsupporting

confidence: 93%

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Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study

Yuan

Sun

et al. 2020

BMC Pregnancy Childbirth

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Background: Thyroid autoimmunity (TAI) and subclinical hypothyroidism (SCH) have been associated with poor pregnancy and fetal outcomes. However, whether euthyroid women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy and fetal outcomes is debatable. Therefore, this study aimed to investigate the association between TPOAb positivity and pregnancy-related and fetal outcomes in euthyroid women. Methods: In total, 938 pregnant women participated in this prospective cohort study. The euthyroid group included 837 pregnant women and the TPOAb-positive group included 101 euthyroid pregnant women. Serum TPOAb, thyroglobulin antibody (TGAb), thyroid-stimulating hormone (TSH), and free thyroxine (FT4) levels were assessed. Pregnancy and fetal outcomes included gestational diabetes mellitus, spontaneous abortion, premature rupture of membranes, hypertensive disorders of pregnancy, preterm birth, fetal distress, low birth weight, fetal macrosomia, and small for gestational age infant. Results: Logistic regression analysis showed TPOAb positivity was not associated with an increased risk of poor pregnancy or fetal outcomes in euthyroid women. However, TPOAb-positive euthyroid women pregnant with a female fetus were independently associated with preterm births (OR: 4.511, 95% CI: 1.075-18.926) after adjustment for potential confounding factors.

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Section: Discussionsupporting

confidence: 93%

“…It should be noted that there are multiple contributing factors between poor pregnancy-related and fetal outcomes. It may be because the impact of TPOAb positivity on poor pregnancy and fetal outcomes in euthyroid women varies with the sex of the fetus, and demographic and obstetric parameters, according to different studies [21,26,42].…”

Section: Discussionmentioning

confidence: 99%

Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study

Yuan

Sun

et al. 2020

BMC Pregnancy Childbirth

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“…One recent cohort ( 12 ) incorporated 1521 European women with thyroid function tests in the first trimester, and manifested that women with normal range TSH levels at upper limit were related to lower neonatal birth weight, with an adjusted odds ratio in reference to the normal group of 21.38 (95%CI, 1.29 to 353.39; P = 0.032). In a real-word data setting or traditional observational design, it was virtually impossible to allow for and adjust for all cofounding conditions such as gestational diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Birth weight is an essential predictor of intrauterine exposures and infant health. Recent studies suggested that normal thyrotropin within the upper reference range or subclinical hypothyroidism may exert positive ( 10 , 11 ), negative ( 12 , 13 ), or null ( 14 , 15 ) effects on offspring birth weight. Apart from the inconsistency, evidence from previous case-control or prospective cohort studies was prone to various confounders.…”

Section: Introductionmentioning

confidence: 99%

Does Maternal Normal Range Thyroid Function Play a Role in Offspring Birth Weight? Evidence From a Mendelian Randomization Analysis

Zhang

Chen

et al. 2020

Front. Endocrinol.

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Background The association between normal range thyroid function and offspring birth weight has been postulated, but evidence from observational studies is prone to be confounded. We conducted a two-sample Mendelian randomization (MR) study to explore the causal effects of maternal thyroid stimulating hormone (TSH) and free thyroxine (FT4) on birth weight. Methods We utilized public shared summary-level statistics from European-ancestry genome wide association studies. We obtained 40 and 21 single nucleotide polymorphisms as instrumental variables, which were associated with TSH and FT4 levels at genome-wide significance ( P < 5 × 10 −8 ). Partitioned maternal effects on birth weight were retrieved from datasets contributed by the Early Growth Genetics Consortium. Inverse-variance weighted method was employed in the primary MR analysis and multiple sensitivity analyses were implemented. Results Genetically determined normal range thyroid function was not causally associated with offspring birth weight. Each one standard deviation (SD) increase in maternal TSH was associated with 0.002 SD higher of birth weight (95% confidence interval [CI], −0.021 to 0.025; P = 0.87). Similarly, change in birth weight was −0.001 SD (95% CI, −0.031 to 0.029; P = 0.94) per one SD higher in maternal FT4. Consistent results were yielded via additional MR methods. Sensitivity analyses demonstrated no presence of horizontal pleiotropy or heterogeneity. Conclusion This MR study did not identify a causality between normal range thyroid function and offspring birth weight in the Europeans.

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“…Normal maternal thyroid function is crucial for a normal pregnancy and fetal growth. During pregnancy, maternal thyroid dysfunction induced pregnancy complications and in uences the fetal developments in utero and later in life [1][2][3]. According to the values of thyroid stimulating hormone (TSH) and free tetraiodothyronine (fT4), thyroid disorders in pregnancy were included subclinical hypothyroidism, hypothyroidism, isolated hypothyroxinemia, subclinical hyperthyroidism, and thyrotoxicosis [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of the effects induced by maternal thyroid dysfunction on obstetrical complications and outcomes

Sun

Wang

Fang

et al. 2020

Preprint

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Background: Abnormal concentrations of maternal thyroid hormones are risk factors for some obstetrical complications. However, the influence induced by different types of maternal thyroid dysfunction on obstetrical complications and outcomes is still controversial.Methods: A total of 17219 pregnant women were drawn for a thyroid function test, including TSH and fT4. All participants were divided into 7 groups, on the basis of their blood tested results, and their pregnancy outcomes were followed up. The isolated hypothyroxinemia group was further divided into 2 cohorts, according to whether they receive levothyroxine. Pregnant complications and outcomes in two cohorts were observed and analyzed.Results: A total of 2621 (15.22%)were identified to have abnormal thyroid function, including 1150 with subclinical hypothyroidism, 526 with gestational transient thyrotoxicosis (GTT), 419 with subclinical hyperthyroidism, 336 with isolated hypothyroxinemia, 78 with hyperthyroidism and 76 with hypothyroidism. Compare to control group, subclinical hypothyroidism, subclinical hyperthyroidism, isolated hypothyroxinemia and hypothyroidism groups presented higher incidence in one or more complications of pregnancy, while, GTT and drug-controlled hyperthyroidism had little significant effect on pregnancy complications. In isolated hypothyroxinemia group, there were no significant difference outcomes between cohorts using levothyroxine and not treatment.Conclusions: Our results showed a high incidence rate of thyroid dysfunction in pregnant women, and subclinical hypothyroidism is most common, followed by GTT. In general, pregnant women with thyroid dysfunction presented high risk of pregnancy complications. Isolated hypothyroxinemia in pregnant women is a matter of concern and treatment with levothyroxine couldn’t improve pregnancy outcomes and obstetrical complications.

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The Impact of Thyroid Disorders on Clinical Pregnancy Outcomes in a Real-World Study Setting

Cited by 22 publications

References 46 publications

Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study

Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study

Does Maternal Normal Range Thyroid Function Play a Role in Offspring Birth Weight? Evidence From a Mendelian Randomization Analysis

Retrospective analysis of the effects induced by maternal thyroid dysfunction on obstetrical complications and outcomes

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