Is Age a Risk Factor for Hypothyroidism in Pregnancy? An Analysis of 5223 Pregnant Women

Potluková, Eliška; Potluka, Oto; Jiskra, Jan; Límanová, Z; Telicka, Zdenek; Bartáková, Jana; Springer, Drahomíra

doi:10.1210/jc.2011-3275

Cited by 46 publications

(31 citation statements)

References 27 publications

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“…In most studies in pregnant women, age > 30 years was not associated with increased serum TSH levels [9, 10, 38, 39] or TAI [39, 40]. In contrast, in the study by Veltri et al [40] serum TSH was significantly lower in women > 30 years, and, in a study by Korevaar et al [9], serum FT4 levels were significantly lower.…”

Section: Established Variables Contributing To Variation In Thyroid Fmentioning

confidence: 95%

Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Veltri

Poppe

2018

Eur Thyroid J

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Variability in thyroid function in pregnant women is the result of 2 main determinants, each accounting for approximately half of it. The first is the genetically determined part of which the knowledge increases fast, but most remains to be discovered. The second determinant is caused by an ensemble of variables of which thyroid autoimmunity is the best known, but also by others such as parity, smoking, age, and BMI. More recently, new candidate variables have been proposed, such as iron, endocrine disruptors, and the ethnicity of the pregnant women. In the future, the diagnosis and treatment of thyroid (dys)function may be optimized by the use of each individual’s pituitary-thyroid set point, corrected with a factor taking into account the impact of nongenetically determined variables.

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Section: Established Variables Contributing To Variation In Thyroid Fmentioning

confidence: 95%

Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Veltri

Poppe

2018

Eur Thyroid J

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“…With current increases in potential risk factors, the efficiency of the screening method has also increased. As Potlukova et al (26) reported, by including age R30 years as a risk factor, the sensitivity of high-risk case finding strategy increased from 55.3-85.6%.…”

Section: Introductionmentioning

confidence: 95%

“…While American Thyroid Association and European societies guidelines considered ageR 30 years as a risk factor and suggested screening all women over the age of 30 years, there is insufficient evidence on the association between age and abnormal thyroid function (31). It has been shown that the addition of women age R30 years increased the proportion of women identified in a case finding approach from 55.3 to 85.6% (26). It seems that due to wide differences in the prevalence of these risk factors in various communities (32,33), thyroid screening policies need to be evidence-based for each society (27).…”

Section: Characteristicsmentioning

confidence: 99%

Comparison of universal screening with targeted high-risk case finding for diagnosis of thyroid disorders

Nazarpour

Tehrani

Simbar

et al. 2016

European Journal of Endocrinology

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Objective: Debate about the need for universal screening of thyroid dysfunction in pregnancy is ongoing. The present study aimed to compare universal screening with targeted high-risk case findings for early diagnosis of thyroid disorders in Iranian pregnant women. Study design: This cross-sectional prospective study was carried out on 1600 pregnant women in their first trimester. A checklist, including all related risk factors recommended by The American Thyroid Association, was completed for all participants. Serum concentrations of thyroxine (T 4 ), T-uptake, TSH and thyroid peroxidase antibody (TPOAb) were measured and thyroid status was documented, based on hormonal measurements and clinical examinations. Results: There were 656 women (44.3%) that had at least one risk factor for thyroid diseases and were eligible for the targeted high-risk case finding (high-risk group) approach, while 55.7% had no risk factors (low-risk group). Using the universal screening approach, there were 974 women (65.8%) with normal thyroid status and 506 participants (34.2%) with thyroid disturbances, including overt hyperthyroidism (0.7%), overt hypothyroidism (1.1%), subclinical hypothyroidism (30.1%; positive TPOAb (5.5%) and negative TPOAb (24.6%); and euthyroid and positive TPOAb (2.3%). Of women with thyroid dysfunction, 64.4% were in the high-risk group and 35.6% were in the low-risk group (P!0.0001). Conclusions: The targeted high-risk case finding approach overlooks about one-third of pregnant women with thyroid dysfunction. If ongoing prospective trials provide evidence on the efficacy of treating subclinical hypothyroidism in pregnancy, in populations with a low prevalence of presumed risk factors, the targeted high-risk case finding approach will be proven inefficient.

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“…3 Age more than thirty years was not found to be associated with maternal hypothyroidism in the study conducted by Potlukova et al which was similar to the present study where only 20% cases belonged to that age group. 4 In a study conducted on pregnant women in Bangladesh, hypothyroidism was associated with development of gestational diabetes. 5 In another study by Mannisto et al it was observed that hypothyroid pregnant women have increased odds for developing this complication.…”

Section: Discussionmentioning

confidence: 99%

Outcome of clinical hypothyroidism in pregnancy: a case control study

Lopamudra

Reddi

Ghose

2016

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONThyroid gland dysfunctions in the form of hypo or hyperthyroidism have been known to have a deleterious effect on fertility as well as pregnancy. The various hypofunction thyroid disorders encountered in pregnant women are clinical or clinical and subclinical hypothyroidism. Pregnancy itself modifies thyroid gland functions in the form of 50% increase in thyroxine (T4) and triiodothyronine (T3) production, decreased levels of thyrotropin (TSH) due to effect of human chorionic gonadotropin and 50% increase in daily iodine requirement.1 Clinical hypothyroidism is defined as decreased free thyroxine levels with an increased value of thyrotropin (>2.5miu/L). This has been associated with increased incidence of gestational hypertension and diabetes, preterm delivery and Caesarean section in pregnant women.2 This study is undertaken to find out the effects of adequately treated clinical hypothyroidism in pregnancy when compared with pregnant euthyroid controls. METHODSThis study was conducted in a tertiary care centre over a period of one year and 144 cases of clinical hypothyroidism in pregnancy were taken into account who formed the case group. Inclusion criteriaNewly diagnosed clinical hypothyroidism in pregnancy, TSH>2.5 mIU/L in 1 st and 3mIU/L in the 2 nd and 3 rd trimesters respectively according to American thyroid association guidelines. ABSTRACTBackground: Hypothyroidism in pregnancy is generally associated with various adverse outcomes. Also worldwide, there is an increased awareness about morbidity caused by this endocrinological disorder in pregnancy .This study is undertaken to evaluate the outcome of this condition in pregnancy. Methods: 144 newly diagnosed clinical hypothyroid pregnant women were taken as the case group and 145 age and parity matched euthyroid pregnant women were taken as controls. The outcome compared in between these two groups were pregnancy complications like gestational diabetes and hypertension , oligohydramnios, intrauterine growth restriction , intrauterine demise, Caesarean section rates and it's indication as well as neonatal outcome like birth weight and need for neonatal intensive care.Results: Clinical hypothyroidism in pregnancy constituted 6.1% of the total number of deliveries. There was a significantly higher number of gestational diabetes in the case group (p=0.0001). Caesarean sections done for the indication of foetal distress was significantly higher when compared with the control group (p=0.00002). Large for gestational age babies were more common in case group. Conclusions: Clinical hypothyroidism in pregnancy even when treated adequately might lead to complications.

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Is Age a Risk Factor for Hypothyroidism in Pregnancy? An Analysis of 5223 Pregnant Women

Abstract: Prevalence of autoimmune thyroid disease does not increase with age in pregnant women; however, addition of age 30 or over to the case-finding screening strategy may substantially improve its efficiency due to a larger number of women screened.

Cited by 46 publications

References 27 publications

Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Variables Contributing to Thyroid (Dys)Function in Pregnant Women: More than Thyroid Antibodies?

Comparison of universal screening with targeted high-risk case finding for diagnosis of thyroid disorders

Outcome of clinical hypothyroidism in pregnancy: a case control study

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