Thyroxine concentration and outcome of hyperemetic pregnancies

Chin, Robert; Lao, Tth

doi:10.1111/j.1471-0528.1988.tb12806.x

Cited by 28 publications

(5 citation statements)

References 9 publications

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“…Vol 71'No 2 dicated that free hormones remained unchanged (44)(45)(46), decreased (11,12,15,47,48), or even increased (16,49,50). Although controversies will not be resolved by the présent study, it may help to clarify the debate.…”

Section: Discussionmentioning

confidence: 99%

Regulation of Maternal Thyroid during Pregnancy*

Glinoer

Nayer²,

Bourdoux³

et al. 1990

The Journal of Clinical Endocrinology & Metabolism

653

379

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A prospective study was undertaken in 606 healthy women during pregnancy to evaluate the changes occurring in maternal thyroid economy as a result of 1) the increased thyroid hormone-binding capacity of serum, 2) the effects of increased levels of hCG on TSH and on the thyroid, and 3) a marginally low iodine intake in the population (50-75 micrograms/day). Four main features were observed. First, thyroidal activity adjusted to the marked increase in serum T4-binding globulin: pregnancy was accompanied by an overall reduction in the T4/T4-binding globulin ratio, with lower free T4 and T3 levels, although in most cases free hormone levels remained within the normal range. The adjustment of thyroidal output of T4 and T3 did not occur similarly in all subjects. In approximately one third of the women, there was relative hypothyroxinemia, higher T3/T4 ratios (presumably indicating preferential T3 secretion), and higher, although normal, serum TSH concentrations. Second, high hCG levels were associated with thyroid stimulation, both functionally (lower serum TSH) and anatomically (increased thyroid size). The data are consistent with a TSH-like effect of hCG on the thyroid. Hence, regulation of the maternal thyroid is complex, resulting from both elevated hCG (mainly in the first half of gestation) and increasing TSH (mainly in the second half of gestation). Third, a significant increase in serum thyroglobulin levels was observed throughout gestation, especially during the last trimester. Fourth, increased thyroid volume was common, and goiter formation not uncommon (goiter was found in 9% of women at delivery). In conclusion, the alterations in maternal thyroid function during gestation are intricate and far from fully understood. In areas of marginally low iodine intake, gestation is associated in a significant number of women with relative hypothyroxinemia, increased thyroglobulin, and enlarged thyroid.

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Section: Discussionmentioning

confidence: 99%

Regulation of Maternal Thyroid during Pregnancy*

Glinoer

Nayer²,

Bourdoux³

et al. 1990

The Journal of Clinical Endocrinology & Metabolism

653

379

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“…(2)(3)(4)(5)(6)(7)(8)(9) Goodwin vond in zijn studie, verricht bij 67 vrouwen met hyperemesis gravidarum, dat 70% een biochemische hyperthyroidie (gestegen FT 4 -index en gedaald TSH) vertoonden en dat de graad van hyperthyroidie in verband stond met de ernst van hyperemesis. Slechts 6 van de 67 vrouwen vertoonden eveneens een gestegen FT 3 ; zij waren het meest ziek. Deze preferentiële stijging van FT 4 t.o.v.…”

Section: Inleidingunclassified

“…Verder bestaat er geen verband tussen de ernst van hyperemesis gravidarum en de graad van schildklierstimulatie. Of behandeling met antithyroidea in de groep patiënten met echte hyperthyroidie met gestegen FT 4 en FT 3 …”

Section: Is There a Relation Between Hyperemesis Gravidarum And Hyperunclassified

Is Er Een Relatie Tussen Hyperemesis Gravidarum en Hyperthyroidie?

Leunen¹,

Velkeniers²,

Verlaenen

2001

Acta Clinica Belgica

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In patients admitted with hyperemesis gravidarum, we found 23% of the women to present a thyroid stimulation. This hyperthyroidism differs from the auto-immune hyperthyroidism, i.e. the patients have no thyroid antibodies, no classic clinical signs of thyrothoxicosis. Probably, the absolute hCG concentration and its biological activity plays a crucial role in the thyroid stimulation. This degree of thyroid stimulation has no influence on the severity of the hyperemesis gravidarum, neither on the outcome of the pregnancy.

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“…Gestations of 24-28 weeks were cho sen because all of our patients had been fully assessed by this stage of pregnancy and because hyperthyroxinemia at this stage may have some effect on the outcome of pregnancy even in patients without underlying hyperthy roidism [4],…”

Section: Introductionmentioning

confidence: 99%

Second-Trimester Thyroid Function and Pregnancy Outcome in Mothers with Hyperthyroidism

Lao¹,

Chin²,

Mak³

et al. 1991

Gynecol Obstet Invest

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Thyroid function at 24–28 weeks gestation was compared between 26 mothers with hyperthyroidism (16 on antithyroid treatment and 10 in remission without treatment) and 15 normal pregnant controls. There was no difference in the total and free thyroxine (TT₄ and FT₄) or in the total and free triiodothyronine (TT₃ and FT₃) concentrations, but the erythrocyte zinc (RBC Zn) concentration was significantly lower in the study group (187.3 ± 46.6 µmol/l RBC versus 223.6 ± 3.7 µmol/l RBC, p < 0.01). In the study group, both birth weight and gestation at delivery were significantly correlated with TT₃ (r = ––0.500, p < 0.02 and r = ––0.460, p < 0.05, respectively) as well as with RBC Zn (r = 0.473, p < 0.02 and r = 0.573, p < 0.01, respectively). The results suggest that plasma concentration of TT₃ and of RBC Zn at 24–28 weeks gestation may be helpful prognostic factors in the management of pregnant patients with hyperthyroidism.

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Thyroxine concentration and outcome of hyperemetic pregnancies

Cited by 28 publications

References 9 publications

Regulation of Maternal Thyroid during Pregnancy*

Regulation of Maternal Thyroid during Pregnancy*

Is Er Een Relatie Tussen Hyperemesis Gravidarum en Hyperthyroidie?

Second-Trimester Thyroid Function and Pregnancy Outcome in Mothers with Hyperthyroidism

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