Establishing trimester-specific maternal thyroid function reference intervals

Khalid, A; Marchocki, Zbigniew; Hayes, Kevin; Lutomski, Jennifer E.; Joyce, Caroline; Stapleton, Mary; O’Mullane, John; O’Donoghue, Keelin

doi:10.1177/0004563213496394

Cited by 18 publications

(10 citation statements)

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“…Incongruent with previous reports, the present results fail to demonstrate influences of parity and gestational age on maternal thyroid function/antibodies (28, 33–35). A cross-sectional study conducted in 50 non-pregnant women as a control group, 50 primiparae and 50 multiparae women showed increased serum levels of T4 and T3 in both groups, while serum level of TSH decreased significantly in the two groups (35).…”

Section: Discussionsupporting

confidence: 67%

“…Based on the data used to establish pregnancy-specific thyroid function reference intervals of a southern Chinese population, TSH is likely to increase while thyroid hormones decrease in advanced gestational ages (28). The same findings were reproduced by Khalid and his group when they studied thyroid function in pregnant women attending a large, tertiary referral maternity hospital in Ireland (33). In addition, the study by Khalid et al documented significant positive correlation between anti-TPO antibodies, gestational age and TSH, but not T4.…”

Section: Discussionsupporting

confidence: 62%

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Thyroid Function/Antibodies in Sudanese Patients with Preeclampsia

et al. 2015

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Preeclampsia is an important cause of maternal and prenatal morbidity and mortality in the developing countries. Changes in thyroid function/antibodies profiles in preeclamptic women are controversial and were never investigated before in Sudan. A case–control study was conducted at Medani Hospital, Sudan, to investigate thyroid function/antibodies in preeclampsia. The sociodemographic, medical history was gathered using questionnaires. Thyroid hormones [thyroid-stimulating hormone (TSH), free tri-iodothyronine (T3), and free thyroxine (T4)] and anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were measured using ELISA. The three groups [controls, mild, and severe preeclampsia (SP) (55 women in each arm)] were matched in age and parity. While median (interquartile range) of TSH was significantly lower, both free T3 and free T4 levels were significantly higher in women with preeclampsia than in the healthy controls. There was no significant difference in the TSH levels in women with MP and SP. In comparison with women with MP, women with SP had significantly higher levels of free T3 and significantly lower levels of free T4. While anti-TPO antibodies were significantly higher, anti-TG antibodies were significantly lower in women with preeclampsia. Likewise, anti-TPO antibodies were significantly higher and anti-TG antibodies were significantly lower in women with SP than in women with MP. In linear regression, preeclampsia was significantly associated with TSH (−0.675 IU/ml, P = 0.009), free T3 (0.977 pg/ml, P < 0.001), and free T4 (0.186 ng/dl, P < 0.001) levels. In contrast to anti-TG antibodies and TSH, Sudanese patients with preeclampsia had higher levels of T3 and T4 hormones and anti-TPO antibodies irrespective of parity, gestational age, and hemoglobin levels.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionsupporting

confidence: 62%

Thyroid Function/Antibodies in Sudanese Patients with Preeclampsia

et al. 2015

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“…Additionally, FT4 showed a steady decrease throughout pregnancy (Table 4). The findings of the United Arab Emirates study were reproduced in another two studies that intended to establish TSRRs of thyroid hormones in Korean [33] and Irish [34] women.…”

Section: Discussionmentioning

confidence: 85%

Trimester-specific thyroid hormone reference ranges in Sudanese women

et al. 2016

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BackgroundTrimester-specific reference ranges for T3, T4, and TSH need to be established in different communities. Neither Sudan nor other African countries have established trimester-specific reference ranges for TSH, free T3 (FT3), and free T4 (FT4) in healthy pregnant women. This study aimed to establish trimester-specific reference ranges for TSH, FT3, and FT4 in healthy pregnant Sudanese women.ResultsWe performed a longitudinal study, which included 63 women with singleton pregnancies who were followed since early pregnancy until the third trimester. The study was performed in Saad Abu-Alela Hospital, Khartoum, Sudan, during January to October 2014. An equal number of age- and parity-matched non-pregnant women were enrolled as a control group. Basic clinical and obstetrics data were gathered using questionnaires. TSH, FT3, and FT4 levels were measured. Median (5th–95th centile) values of TSH, FT3, and FT4 were 1.164 IU/ml (0.079–2.177 IU/ml), 4.639 nmol/l (3.843–6.562 nmol/l), and 16.86 pmol/l (13.02–31.48 pmol/l) in the first trimester. Median values of TSH, FT3, and FT4 were 1.364 IU/ml (0.540–2.521 IU/ml), 4.347 nmol/l (3.425–5.447 nmol/l), and 13.51 pmol/l (11.04–31.07 pmol/l) in the second trimester. These values were 1.445 IU/ml (0.588–2.460 IU/ml), 4.132 nmol/l (3.176–5.164 nmol/l), and 12.87 pmol/l (9.807–23.78 pmol/l) in the third trimester, respectively. TSH levels increased throughout the trimesters. FT3 and FT4 levels were significantly higher in the first trimester compared with the second and third trimesters. TSH, FT3, and FT4 levels were significantly lower in pregnant women compared with non-pregnant women (P < 0.001).ConclusionsThe present study is the first to establish trimester-specific reference ranges of TSH, FT3, and FT4 in Sudanese women with normal pregnancies. Our results suggest that pregnancy is likely to suppress TSH, T3, and T4 levels in healthy women.

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“…El límite inferior de la normalidad de TSH tambié n varía con la edad gestacional y la població n estudiada 26 . En Españ a se han encontrado valores de 0,1-0,5 mU/l para el primer trimestre, 0,21-0,36 mU/l para el segundo, y 0,29-0,36 mU/l para el tercero [12][13][14][15][16] .…”

Section: Criterios Diagnósticosunclassified