Trimester-specific reference intervals of thyroid function tests in Turkish pregnants

Bulur, Oktay; Atak, Zeliha; Ertuğrul, Derun Taner; Beyan, Eśin; Günakan, Emre; Karakaya, Serdar; Şahin, Kubilay; Dal, Kürşat

doi:10.1080/09513590.2019.1666817

Cited by 6 publications

(9 citation statements)

References 26 publications

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“…For instance, in a recent study from China, based on a data from 46 262 pregnant women 9 the authors suggested a TSH reference range of 0.03‐3.52 mIU/L, for aTPO‐negative women, while among aTPO‐positive women (n = 4628, ie about 10% of the total), first‐trimester TSH ‘reference range’ was 0.05‐4.57 mIU/L. Similar observations suggesting TSH reference range of 0.005‐3.65 mIU/L are based on data from Turkey (n = 1258) 10 . Such a reference range would also effectively include all our women with subclinical hyperthyroidism, with exception of a single patient with TSH <0.005 mIU/L and raised anti‐TSH receptor antibodies, who had incidentally diagnosed Graves’s disease.…”

Section: Discussionsupporting

confidence: 66%

“…Despite the plethora of papers pertaining to thyroid hormone reference ranges in pregnancy, available studies are effectively based on single thyroid hormone measurement 9‐11,13,16,17 . This applies also to affluent European countries, such as Denmark, where thyroid function and aTPO status were recently assessed in 14 323 pregnant women in the first trimester of pregnancy 24 …”

Section: Discussionmentioning

confidence: 99%

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Subclinical thyroid dysfunction in the first trimester of pregnancy: ‘Disease’ versus physiological (pulsatile) variation in TSH concentrations

Lewandowski

Horzelski

Kawalec

et al. 2020

Clinical Endocrinology

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There is no universal agreement regarding reference ranges for TSH and thyroid hormones during pregnancy. For instance, 2011 American Thyroid Association (ATA) guidelines 1 suggested that if trimester-specific reference ranges for TSH are not available, the following reference ranges are recommended: first trimester, 0.1-2.5 mIU/L; second trimester, 0.2-3.0 mIU/L; and third trimester, 0.3-3.0 mIU/L. Such position was repeated in the Endocrine Society 2 and European Thyroid Association guidelines, 3 while subsequent 2017 ATA guidelines 4 suggested a higher cutoff point of TSH 4.0 mIU/L.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Subclinical thyroid dysfunction in the first trimester of pregnancy: ‘Disease’ versus physiological (pulsatile) variation in TSH concentrations

Lewandowski

Horzelski

Kawalec

et al. 2020

Clinical Endocrinology

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“…al. 15 found their reference intervals for TSH as 0.005-3.65 mIU/L for the first, 0.011-3.63 mIU/L for the second and 0.2-3.46 mIU/L for the third trimesters. The upper limits in that study were higher than the fixed 2011 ATA guideline upper limits and our upper reference limits.…”

Section: Discussionmentioning

confidence: 94%

“…Several studies were carried out following the recommendations of recent guidelines about population-based reference intervals of thyroid hormones in pregnant women 3,[14][15][16] . To the best of our knowledge, there were only two studies that emerged from our country 14,15 at the time of writing this paper. In these studies, 2.5 and 97.5 percentiles were taken as reference intervals.…”

Section: Discussionmentioning

confidence: 99%

Trimester Specific Reference Ranges for Thyroid Hormones in Pregnancy with Multiples of Median Values

Tekin¹,

Yassa²,

Toklucu³

et al. 2022

NKTD

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Popülasyon ve laboratuvara özgü tiroid hormonları için trimester spesifik rasyonel referans aralıkları oluşturmaktır.Gereç ve Yöntem: Çalışma üçüncü basamak bir sağlık kuruluşunda kadın doğum polikliniğinde Nisan 2021-Ağustos 2021 tarihleri arasında gerçekleştirildi. Her üç trimesterde de herhangi bir risk faktörü ve antitiroperoksidaz pozitifliği olmayan sağlıklı gebeler çalışmaya alındı. Serum tiroid stimülan hormon (TSH), serbest tiroksin (FT4) ve serbest triiyodo-tironin (FT3) düzeyleri elektrokemilüminesans tekniği ile ölçüldü. Trimester spesifik referans aralıkları, medyan değerlerin katları (MoM) ile TSH, FT3 ve FT4 değerlerinin 5. ve 95. persentilleri belirlendi.Bulgular: Toplamda, 140'ı birinci trimesterde, 204'ü ikinci trimesterde ve 140'ı üçüncü trimesterde olmak üzere 484 sağlıklı gebe çalışmaya alındı. İlk trimester için kadınların %90'ı (n=126) referans sınırlarındaydı (0,19-3,25 uIU/mL ve 0,19-3,25 MoM) ve %11,1'inin (n=14) TSH seviyeleri 2,5 uIU/L'nin üzerindeydi. İkinci trimester için, %90,2 (n=184) referans sınırlarında (0,65-3,83 uIU/mL ve 0,4-2,36 MoM) TSH seviyelerine sahipti ve

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“…Inconsistent reference intervals were established by different testing systems, different regions and populations. 17,18,[23][24][25][26][27][28][29][30] The reference interval varies between manufacturers and testing platforms among the stages of pregnancy. As recommended by the CLSI, each laboratory in each region should establish its own reference interval for TSH in pregnant women.…”

Section: Comparison Of Tsh and Ft4 Ris In Pregnant Women Across Previ...mentioning

confidence: 99%

Establishment of trimester-specific reference intervals for thyroid stimulating hormone and free thyroxine during pregnancy in southwest China by indirect method

et al. 2021

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Objective A series of physiological changes in thyroid function occur during pregnancy and differ from those non-pregnant women. This study aimed to establish the pregnancy-specific reference intervals of TSH and FT4 using an indirect method based on the healthy pregnant women from southwest China population. Methods Thyroid function test results which available on the Laboratory Information System (LIS) were collected from the pregnancies who visited the Obstetric Clinic or the Department of Gynecology between 1 January 2015, and 30 December 2020. We grouped the data by trimesters to establish the reference intervals (RIs) based on the clinical consensus of different levels of TSH and FT4 at different weeks of gestation. All arrangements were referenced to the document CLSI EP28-A3C. Results A total of 33,040 thyroid function test results of pregnant women, aged 31 (28,33) years were statistical analyzed. Estimated RIs for TSH and FT4 in the first, second and third trimesters corresponding to the 2.5th and 97.5th percentiles in TPOAb negative were 0.02–5.23, 0.03–5.24, 0.37–5.68 mIU/L, 11.66–20.69, 10.1–18.59, 9.85–16.86pmol/L, respectively. Conclusion This study provides trimester-specific RIs for TSH and FT4 among healthy pregnant women in southwest China which guides clinicians to diagnosis and screen for thyroid disorders in this region.

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Trimester-specific reference intervals of thyroid function tests in Turkish pregnants

Cited by 6 publications

References 26 publications

Subclinical thyroid dysfunction in the first trimester of pregnancy: ‘Disease’ versus physiological (pulsatile) variation in TSH concentrations

Subclinical thyroid dysfunction in the first trimester of pregnancy: ‘Disease’ versus physiological (pulsatile) variation in TSH concentrations

Trimester Specific Reference Ranges for Thyroid Hormones in Pregnancy with Multiples of Median Values

Establishment of trimester-specific reference intervals for thyroid stimulating hormone and free thyroxine during pregnancy in southwest China by indirect method

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