Thyroid disease and gestational diabetes mellitus (GDM): is there a connection?

Stohl, Hindi E.; Ouzounian, Joseph G.; Rick, Anne-Marie; Hueppchen, Nancy A.; Bienstock, Jessica L.

doi:10.3109/14767058.2013.773309

Cited by 18 publications

(14 citation statements)

References 16 publications

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“…Of these, most were excluded after the first screening based on abstract and/or title, and 17 citations were retained. Six studies [18][19][20][21][22][23] were excluded after fulltext review of the 17 articles. Finally, 11 cohort studies [24][25][26][27][28][29][30][31][32][33][34] including 56 055 pregnant women, of whom 3903 had SCH, were included in the analysis ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Meta‐analysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus

Jia

Lin

et al. 2019

Intl J Gynecology & Obste

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Background Subclinical hypothyroidism (SCH) and gestational diabetes mellitus (GDM) are common endocrine disorders that occur during pregnancy. Objective To determine whether the risk of GDM differs between pregnant women with normal thyroid function and those with SCH. Search strategy MEDLINE, EMBASE, the Cochrane Library, and Web of Science were searched for studies published in English from inception to March 1, 2017, using combinations of the search terms “thyroid dysfunction”, “thyroid diseases”, “subclinical hypothyroidism”, “hypothyroxinemia”, “thyrotropin”, “gestational diabetes”, “hyperglycemia in pregnancy”, and “adverse pregnancy outcomes”. Selection criteria We selected cohort studies that included pregnant women with SCH; in which the outcome of interest was, or included, the incidence of GDM; and that had data available for both the SCH and GDM groups. Studies were excluded if assisted reproductive technologies were used to achieve pregnancy; reviews, abstracts, and case reports were also excluded. Data collection and analysis Eleven studies were included in the analysis. Summary odds ratios (ORs) for the risk of GDM were calculated. Main results SCH with positive antithyroid autoantibodies markedly increased GDM risk (OR 3.22, 95% confidence interval 1.72–6.03, I2=55%). Conclusion SCH with positive antithyroid autoantibodies in pregnancy is associated with an increased risk of GDM.

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Section: Resultsmentioning

confidence: 99%

Meta‐analysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus

Jia

Lin

et al. 2019

Intl J Gynecology & Obste

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“…Different diagnosis criteria of GDM have been used in different studies examining the relationship between SCH and GDM, and this may also lead to the inconsistent results. Currently, there is lack of unified diagnostic criteria for GDM and separate studies adopted the test methods and the cut-offs according their own national guidelines [17][18][19][20] . In our study, we used the IADPSG diagnosis criteria that is accepted by many countries [17,21,22] .…”

Section: " Discussionmentioning

confidence: 99%

Maternal Subclinical Hypothyroidism in the first trimester is not Associated with Gestational Diabetes Mellitus

Li¹,

Chen²,

Cui³

et al. 2019

Preprint

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Background: To explore the association between subclinical hypothyroidism (SCH) during the first trimester and gestational diabetes mellitus (GDM) that was happened later on in our cohort. Methods: A total of 6530 pregnant women who first visited before 13 +6 gestational weeks and accepted routinely prenatal services in the third affiliated hospital of Sun Yat-Sen University from January 2015 to September 2018 were finally met the inclusion criteria and recruited. Thyroid functions (TSH, free T4 (FT4) and TPOAb) were performed at the first visit and a 2h 75-g oral glucose tolerance test was performed between 24-28 weeks. Chi-square test and multivariate logistic regression were used to evaluate the association between SCH and GDM. Results: Though SCH group was divided into subgroups according TPOAb status and TSH levels, the incidence of GDM was no change when compared with the normal group (all P > 0.05). No matter adjusting or not for maternal age, maternal pregestational body max index, parity and educational level, the results showed elevated TSH was not associated GDM (all P > 0.05). TPOAb status also had no effect on the incidence of GDM either before or after adjustment ( P > 0.05). Conclusion: Maternal SCH in the first trimester was not associated with GDM, regardless of the TPOAb status or the TSH levels.

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“…2 A higher association of Caesarean deliveries was found between hypothyroid women with concurrent gestational diabetes by Tirosh et al as well as by Stohl et al 12,13 However, in the Turkish study by Kumru et al, no association was found between thyroid dysfunction and Caesarean section rates. 7 In this study, though the Caesarean rates were not significantly higher in the study group compared to the control, but there was a statistically significant number of Caesarean sections being done for the indication of foetal distress (p=0.00002) with 18.7% deliveries complicated by meconium stained liquor.…”

Section: Discussionmentioning

confidence: 51%

Outcome of clinical hypothyroidism in pregnancy: a case control study

Lopamudra

Reddi

Ghose

2016

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONThyroid gland dysfunctions in the form of hypo or hyperthyroidism have been known to have a deleterious effect on fertility as well as pregnancy. The various hypofunction thyroid disorders encountered in pregnant women are clinical or clinical and subclinical hypothyroidism. Pregnancy itself modifies thyroid gland functions in the form of 50% increase in thyroxine (T4) and triiodothyronine (T3) production, decreased levels of thyrotropin (TSH) due to effect of human chorionic gonadotropin and 50% increase in daily iodine requirement.1 Clinical hypothyroidism is defined as decreased free thyroxine levels with an increased value of thyrotropin (>2.5miu/L). This has been associated with increased incidence of gestational hypertension and diabetes, preterm delivery and Caesarean section in pregnant women.2 This study is undertaken to find out the effects of adequately treated clinical hypothyroidism in pregnancy when compared with pregnant euthyroid controls. METHODSThis study was conducted in a tertiary care centre over a period of one year and 144 cases of clinical hypothyroidism in pregnancy were taken into account who formed the case group. Inclusion criteriaNewly diagnosed clinical hypothyroidism in pregnancy, TSH>2.5 mIU/L in 1 st and 3mIU/L in the 2 nd and 3 rd trimesters respectively according to American thyroid association guidelines. ABSTRACTBackground: Hypothyroidism in pregnancy is generally associated with various adverse outcomes. Also worldwide, there is an increased awareness about morbidity caused by this endocrinological disorder in pregnancy .This study is undertaken to evaluate the outcome of this condition in pregnancy. Methods: 144 newly diagnosed clinical hypothyroid pregnant women were taken as the case group and 145 age and parity matched euthyroid pregnant women were taken as controls. The outcome compared in between these two groups were pregnancy complications like gestational diabetes and hypertension , oligohydramnios, intrauterine growth restriction , intrauterine demise, Caesarean section rates and it's indication as well as neonatal outcome like birth weight and need for neonatal intensive care.Results: Clinical hypothyroidism in pregnancy constituted 6.1% of the total number of deliveries. There was a significantly higher number of gestational diabetes in the case group (p=0.0001). Caesarean sections done for the indication of foetal distress was significantly higher when compared with the control group (p=0.00002). Large for gestational age babies were more common in case group. Conclusions: Clinical hypothyroidism in pregnancy even when treated adequately might lead to complications.

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Thyroid disease and gestational diabetes mellitus (GDM): is there a connection?

Abstract: If larger studies confirm the trends observed in our study, consideration should be given to including women with known thyroid disease in the subset of women who should be offered screening for diabetes early in pregnancy and appropriate clinical surveillance.

Cited by 18 publications

References 16 publications

Meta‐analysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus

Meta‐analysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus

Maternal Subclinical Hypothyroidism in the first trimester is not Associated with Gestational Diabetes Mellitus

Outcome of clinical hypothyroidism in pregnancy: a case control study

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