Variability in Thyroid-Stimulating Hormone Suppression by Human Chronic Gonadotropin during Early Pregnancy

Haddow, James E.; McClain, Monica R.; Lambert-Messerlian, Geralyn; Palomaki, Glenn E.; Canick, Jacob A.; Cleary-Goldman, Jane; Malone, Fergal D.; Porter, T. Flint; Nyberg, David A.; Bernstein, Peter S.; D’Alton, Mary E.

doi:10.1210/jc.2008-0568

Cited by 83 publications

(50 citation statements)

References 25 publications

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“…w e demonstrate elevated T4 she is really in state o f concluded that the induced elevation of T4 may b e hyperthyroidism but, it is the new physiological condition responsible for the morning sickness, nausea and and the metabolic regulation of pregnant women which vomiting of first-trimester of pregnancy, this finding is in realized and on that base, extra thyroxin requirement is agreement with many other studies in different part of requested, T4 is elevated, not for the sake o f the world (Al-Yatama et al, 2002;Caffrey, 2000; hyperthyroidism, but for the sake growing fetus demand Haddow et al, 2008;Sheehan, 2007). and the maternal new physiological conditions, therefore Laboratory assessment of thyroid function test the establishment of reference intervals and the during early stage of pregnancy and measurement of TSH, methodology of thyroid hormone measurements in each T4,T3,TBG, hCG and thyroid auto-antibodies, all help the region is a great importance (Dash et al, 2005).…”

Section: During Pregnancysupporting

confidence: 84%

Thyroid Function Tests During First-trimester of Pregnancy: A Review of Literature

Mansourian¹

2010

Pakistan J. of Biological Sciences

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This literature review was conducted to summarize the main points of maternal thyroid function tests, with particular attention in the first trimester of pregnancy which accompanied with significant biochemical and metabolic alteration. The evaluation of thyroid function of either hyperthyroidism and hypothyroidism should be assessed by determination of serum Thyroid Stimulating Hormone (TSH), Thyroxine (T4), Triiodothyronine (T3), Iodine and Thyroid Autoantibodies. Glomerular filtration rate is increased during pregnancy; therefor iodine deficiency should be evaluated during the pregnancy to prevent hypothyroidism. The role which can be played by Human Chronic Gonadotropin (hCG) on stimulating the thyroid gland to become over-active was investigated. Serum level of thyroglobulin (Tg) and Thyroxin Binding Globulin (TBG) should be assessed for proper assessments of thyroid gland during pregnancy. Thyroid function tests during first-trimester of pregnancy and particularly the reference interval for thyroid function tests for pregnant women in each region has to be established, to prevent mis-diagnosis and irreversible mental and physical adverse affect for growing fetus.

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Section: During Pregnancysupporting

confidence: 84%

Thyroid Function Tests During First-trimester of Pregnancy: A Review of Literature

Mansourian¹

2010

Pakistan J. of Biological Sciences

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“…On the base of published studies, mostly from western countries, either the guidelines sponsored by the American Thyroid Association or by the American Endocrine Society suggested the following reference range: first trimester, 0.1 to 2.5 mU/l; second trimester, 0.2 to 3.0 mU/l; third trimester, 0.3 to 3.0-3.5 mU/l [6,9,15,16,17]. …”

Section: Diagnosis Of Sch In Pregnancymentioning

confidence: 99%

“…Available data derived from the literature indicate that in the first trimester the lower FT 4 limit (2.5th percentile) of the reference range, detected by immunoassay, is around 0.80 ng/dl (10.30 pmol/l) [16,17,27,28]. Given the uncertainty in FT 4 measurement during pregnancy, alternative strategies have also been suggested.…”

Section: Diagnosis Of Sch In Pregnancymentioning

confidence: 99%

2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children

Lazarus¹,

Brown²,

Daumerie³

et al. 2014

Eur Thyroid J

585

457

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This guideline has been produced as the official statement of the European Thyroid Association guideline committee. Subclinical hypothyroidism (SCH) in pregnancy is defined as a thyroid-stimulating hormone (TSH) level above the pregnancy-related reference range with a normal serum thyroxine concentration. Isolated hypothyroxinaemia (defined as a thyroxine level below the 2.5th centile of the pregnancy-related reference range with a normal TSH level) is also recognized in pregnancy. In the majority of SCH the cause is autoimmune thyroiditis but may also be due to iodine deficiency. The cause of isolated hypothyroxinaemia is usually not apparent, but iodine deficiency may be a factor. SCH and isolated hypothyroxinaemia are both associated with adverse obstetric outcomes. Levothyroxine therapy may ameliorate some of these with SCH but not in isolated hypothyroxinaemia. SCH and isolated hypothyroxinaemia are both associated with neuro-intellectual impairment of the child, but there is no evidence that maternal levothyroxine therapy improves this outcome. Targeted antenatal screening for thyroid function will miss a substantial percentage of women with thyroid dysfunction. In children SCH (serum TSH concentration >5.5-10 mU/l) normalizes in >70% and persists in the majority of the remaining patients over the subsequent 5 years, but rarely worsens. There is a lack of studies examining the impact of SCH on the neuropsychological development of children under the age of 3 years. In older children, the evidence for an association between SCH and impaired neuropsychological development is inconsistent. Good quality studies examining the effect of treatment of SCH in children are lacking.

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“…These findings are in consistent with the findings of some researchers. 15,16 On the contrary, some other researchers had shown a lower level of serum FT 4 17 and higher level of serum TSH 18 in normal pregnant women during 1 st trimester in comparison to non pregnant women. 18% of normal pregnant women during 1 st trimester had TPO-Ab positivity in this study whereas, this finding was different in other countries 19 .…”

Section: Discussionmentioning

confidence: 89%

Distribution of thyroid peroxidase positivity and its effects on thyroid function in normal pregnant women during 1st trimester in Dhaka city

Sultanaa

Jahan²,

Sultana³

et al. 2014

Update Dent. Coll. j

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Objective: To measure the distribution of TPO-Ab positivity and to observe the effect of thyroid peroxidase positivity on thyroid function during first trimester in normal pregnancy. Method: A cross sectional among 120 subjects were taken in this study and divided into control and study groups. Control group (Group A) consisted of 60 healthy non pregnant women age ranged between 20 to 35 years. Study group (Group B) consisted of 60 normal pregnant women of same age range. Group B was further subdivided into group B 1 and group B 2 according to the level of TPO-Ab. Group B 1 consisted of TPO-Ab positive pregnant women and group B 2 consisted of TPO-Ab negative pregnant women. Control group was selected from personal contacts and study group from Out Patient Department (OPD) of Obstetrics and Gynecology of Sir Salimullah Medical College and Mitford Hospital. For assessment of thyroid function, serum free thyroxine (FT 4 ), thyroid stimulating hormone (TSH) were measured. Serum FT4, TSH were measured by Enzyme link immunosorbant (ELISA) method. Again, serum TPO-Ab of total study population and hCG of all the pregnant women were measured. Serum TPOAb by Micro particle Enzyme Immunoassay (MEIA) method and hCG was estimated by ELISA. Statistical analysis was done by SPSS version 17. Results: In this study, serum FT 4 and was significantly (P<0.001) higher and TSH level was significantly (P<0.001) lower in normal pregnant women during 1 st trimester in comparison to those of non pregnant women. Again, 18% of pregnant women showed TPO-Ab positivity. However, serum FT 4 level was significantly (P<0.001) lower whereas, TSH level was significantly (p<0.001) higher in TPO-Ab positive pregnant women in comparison to those of TPO-Ab negative pregnant women. Conclusion: TPO-Ab positivity increases during 1st trimester of normal pregnancy which decreases the hyper functional state of thyroid hormones. So, thyroid screening should be done routinely during pregnancy.

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Variability in Thyroid-Stimulating Hormone Suppression by Human Chronic Gonadotropin during Early Pregnancy

Cited by 83 publications

References 25 publications

Thyroid Function Tests During First-trimester of Pregnancy: A Review of Literature

Thyroid Function Tests During First-trimester of Pregnancy: A Review of Literature

2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children

Distribution of thyroid peroxidase positivity and its effects on thyroid function in normal pregnant women during 1st trimester in Dhaka city

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