Gestational Diabetes mellitus and Neonatal Hyperthyrotropinemia

Lao, Terence T.; Lee, Chin-Peng

doi:10.1159/000058363

Cited by 14 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The causal relationship between diabetes in pregnancy and CH is not clear. However, it is well known that maternal diabetes affects embryonic development, leading to increased morbidity in the offspring (27) and a more frequent neonatal hyperthyrotropinaemia has been reported in pregnancies with gestational diabetes than in non-diabetic pregnancies with normal glucose tolerance (28). Our results are also consistent with those obtained by other authors in an experimental model (29).…”

Section: Discussionsupporting

confidence: 93%

Risk factors for congenital hypothyroidism: results of a population case-control study (1997–2003)

Medda¹,

Olivieri²,

Stazi³

et al. 2005

eur j endocrinol

104

View full text Add to dashboard Cite

Objective: To identify risk factors for permanent and transient congenital hypothyroidism (CH). Design: A population-based case-control study was carried out by using the network created in Italy for the National Register of Infants with CH. Methods: Four controls were enrolled for each new CH infant; 173 cases and 690 controls were enrolled in 4 years. In order to distinguish among risk factors for permanent and transient CH, diagnosis was re-evaluated 3 years after enrolment when there was a suspicion of transient CH being present. Familial, maternal, neonatal and environmental influences were investigated. Results: An increased risk for permanent CH was detected in twins by a multivariate analysis (odds ratio (OR) ¼ 12.2, 95% confidence interval (CI): 2.4 -62.3). A statistically significant association with additional birth defects, female gender and gestational age .40 weeks was also confirmed. Although not significant, an increased risk of CH was observed among infants with a family history of thyroid diseases among parents (OR ¼ 1.9, 95% CI: 0.7-5.2). Maternal diabetes was also found to be slightly associated with permanent CH (OR ¼ 15.7, 95% CI: 0.9-523) in infants who were large for gestational age. With regard to transient CH, intrauterine growth retardation and preterm delivery were independent risk factors for this form of CH. Conclusion: This study showed that many risk factors contribute to the aetiology of CH. In particular, our results suggested a multifactorial origin of CH in which genetic and environmental factors play a role in the development of the disease. 153 765-773 European Journal of Endocrinology

show abstract

Section: Discussionsupporting

confidence: 93%

Risk factors for congenital hypothyroidism: results of a population case-control study (1997–2003)

Medda¹,

Olivieri²,

Stazi³

et al. 2005

eur j endocrinol

104

View full text Add to dashboard Cite

show abstract

“…Gestational age, infant gender, age at time of testing, month of birth, mode of delivery, and severity of illness in the neonate, have all been shown to affect the variability in TSH at birth (4, 6). Maternal characteristics such as parity, maternal race, gestational diabetes, and hypertension have all been associated with neonatal thyroid hormone levels; however, many of these studies have been performed with small sample sizes and results have been inconsistent (7–13). …”

Section: Introductionmentioning

confidence: 99%

Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone

Ryckman

Spracklen

Dagle

et al. 2014

Journal of Pediatric Endocrinology and Metabolism

View full text Add to dashboard Cite

Thyroid hormones are important regulators of fetal neurodevelopment. Among preterm infants, TSH is highly variable. Understanding this variability will further improvements in screening for thyroid disorders in preterm infants. We examined 61 maternal and infant clinical and demographic factors for associations with neonatal TSH levels in 698 preterm neonates. TSH was measured as part of routine State-mandated newborn screening in Iowa. Of the maternal characteristics, nulliparous women (P=8x10−4), women with preeclampsia (P=2x10−3), and those with induced labor (P=3x10−3) had infants with higher TSH levels. TSH levels at the time of newborn screening were associated with respiratory distress syndrome (RDS) (P<0.0001) and sepsis (P=3x10−3). We replicated findings between parity and preeclampsia previously observed in primarily term infants. We also observed strong relationships between neonatal TSH and complications of prematurity including RDS and sepsis, which has implications for future studies examining this relationship both prenatally and longitudinally after birth.

show abstract

“…In an earlier study in pregnancies complicated by GDM, transient neonatal hyperthyrotropinemia (>16 mIU/l) was found to be associated with increased incidence of neonatal jaundice requiring treatment [14]. The purpose of the present study is to explore the relationship between high cord blood TSH level and the various perinatal complications in pregnancies complicated by GDM.…”

Section: Introductionmentioning

confidence: 89%

“…The database was set up in a retrospective study on the effect of GDM on pregnancy outcome in Chinese women [18]. Part of this cohort had been examined in a previous study on GDM and high cord blood TSH level by Lao and Lee [14]: hyperthyrotropinemia (TSH >16 mIU/l) was found in 7.2% of the GDM pregnancies and 2.1% of the controls, respectively (p < 0.001). In the present study, we had excluded those with congenital hypothyroidism (those who had low free T 4 and high TSH on repeated testing), multiple pregnancies, fetal malformations, chromosomal abnormalities, stillbirths and those without cord blood TSH results.…”

Section: Methodsmentioning

confidence: 99%

“…Indeed, a number of intrapartum conditions have been shown to affect neonatal thyrotropin level, such as the onset of labor [5], duration of second stage of labor [6], nuchal cord [7], meconium-stained liquor [6], vaginal delivery [8], vaginal breech delivery [9], fetal hypoxemia and acidemia [10, 11], and low Apgar scores [12]. Furthermore, there is also evidence that cord blood TSH level is affected by various antepartum conditions including intrauterine growth retardation [10], preeclampsia [13], gestational diabetes mellitus (GDM) [13, 14]and maternal medical diseases [13]. These findings indicate that apart from congenital hypothyroidism, antepartum and intrapartum stress is another important cause for neonatal hyperthyrotropinemia.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neonatal Hyperthyrotropinemia in Gestational Diabetes mellitus and Perinatal Complications

Leung

Ky²,

Lao³

2004

Neuroendocrinology

Self Cite

View full text Add to dashboard Cite

The aim of this study is to explore the relationship between high cord blood thyroid-stimulating hormone (TSH) level and in-utero stress to the fetus in gestational diabetes mellitus (GDM). Cord blood TSH results were analyzed in 1,578 euthyroid infants from singleton pregnancies with GDM: 103 with elevated TSH (>16 mIU/l) and 1,475 with normal TSH. Maternal characteristics, pregnancy outcome and perinatal complications were compared between the two groups. Multiple logistic regression was used to study the association between high cord blood TSH level and various perinatal complications which reflect in-utero stress in GDM after adjusting for the confounding effects of parity, instrumental delivery, cesarean section and baby gender. High cord blood TSH level was found to be associated with the 1-min Apgar score <7 (OR 3.31, 95% CI 1.78–6.16), birth trauma (OR 3.44, 95% CI 1.11–10.69), neonatal jaundice requiring treatment (OR 2.08, 95% CI 1.30–3.32), neonatal sepsis (OR 2.34, 95% CI 1.24–4.42), respiratory complications (OR 3.45, 95% CI 1.37–8.70), neurological complications (OR 8.01, 95% CI 1.91–33.60) and overall perinatal morbidity (OR 2.41, 95% CI 1.58–3.67). Cord blood TSH level seems to be a better and independent indicator of the in-utero stress to the fetus in GDM when compared to the commonly used sugar profile result and HbA1c level.

show abstract

Gestational Diabetes mellitus and Neonatal Hyperthyrotropinemia

Cited by 14 publications

References 21 publications

Risk factors for congenital hypothyroidism: results of a population case-control study (1997–2003)

Risk factors for congenital hypothyroidism: results of a population case-control study (1997–2003)

Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone

Neonatal Hyperthyrotropinemia in Gestational Diabetes mellitus and Perinatal Complications

Contact Info

Product

Resources

About