Maternal thyroid parameters, body mass index and subsequent weight gain during pregnancy in healthy euthyroid women

Pop, Victor J M; Biondi, Bernadette; Wijnen, Hennie; Kuppens, Simone; LVader, Huib

doi:10.1111/cen.12177

Cited by 54 publications

(60 citation statements)

References 21 publications

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“…BMI has also been associated with both TSH and FT 4 concentrations during pregnancy (21,27,37,41 (21 ). In this context it is noteworthy that the prevalence of overt hypothyroidism in morbidly obese subjects (BMI Ͼ40 kg/m 2 ) was found to be 11.8% (44 ).…”

Section: Factors Influencing Thyroid Function Reference Intervals Durmentioning

confidence: 96%

Thyroid Function in Pregnancy: What Is Normal?

Medici¹,

Korevaar²,

Visser³

et al. 2015

Clinical Chemistry

173

110

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BACKGROUND:Gestational thyroid dysfunction is common and associated with maternal and child morbidity and mortality. During pregnancy, profound changes in thyroid physiology occur, resulting in different thyroidstimulating hormone (TSH) and free thyroxine (FT 4 ) reference intervals compared to the nonpregnant state. Therefore, international guidelines recommend calculating trimester-and assay-specific reference intervals per center. If these reference intervals are unavailable, TSH reference intervals of 0.1-2.5 mU/L for the first trimester and 0.2-3.0 mU/L for the second trimester are recommended. In daily practice, most institutions do not calculate institution-specific reference intervals but rely on these fixed reference intervals for the diagnosis and treatment of thyroid disorders during pregnancy. However, the calculated reference intervals for several additional pregnancy cohorts have been published in the last few years and show substantial variation. CONTENT:We provide a detailed overview of the available studies on thyroid function reference intervals during pregnancy, different factors that contribute to these reference intervals, and the maternal and child complications associated with only minor variations in thyroid function.

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Section: Factors Influencing Thyroid Function Reference Intervals Durmentioning

confidence: 96%

Thyroid Function in Pregnancy: What Is Normal?

Medici¹,

Korevaar²,

Visser³

et al. 2015

Clinical Chemistry

173

110

View full text Add to dashboard Cite

show abstract

“…Obesity has also been recently associated with low FT 4 levels, through mechanisms that are incompletely understood (33,35,48,49,50 (33). One hypothesis regarding these findings, based on the increase in T 3 seen in association with the low T 4 , is that in obesity, there is increased peripheral deiodination (52), as leptin, produced by adipose tissue, is known to stimulate T 4 to T 3 conversion (53,54).…”

Section: Causes Of Imhmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Isolated maternal hypothyroxinemia during pregnancy: knowns and unknowns

Dosiou

Medici

2017

European Journal of Endocrinology

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Isolated maternal hypothyroxinemia (IMH) during pregnancy is defined as a low maternal T 4 in the absence of TSH elevation. As IMH is common, with a prevalence of 1-2% in iodine-sufficient populations, and early research has suggested adverse effects on fetal neurodevelopment, it has been the focus of many studies in the last decade. In the current review, we first discuss the significance of IMH based on data from animal models and recent discoveries regarding the role of thyroid hormone on neurodevelopment. We address issues surrounding the definition and prevalence of this entity and discuss new insights into the etiologies, clinical consequences and management of IMH. A number of large cohort studies have investigated the effects of IMH on the risk of various pregnancy complications and child neurodevelopment. We review these studies in detail and describe their limitations. We discuss the available research on management of IMH, including two recent randomized controlled trials (RCTs). Finally, we delineate the remaining uncertainties in this field and emphasize the need for a sufficiently powered, placebo-controlled RCT on the treatment of IMH early in the first trimester of pregnancy.

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“…and the maternal thyroid measurements are related to both prepregnancy BMI and weight gain throughout gestation [35]. Initial studies of pregnant women in the United States and Europe first led to recommendations for a TSH upper reference limit of 2.5 mIU/L in the first trimester and 3.0 mIU/L in the second and third trimesters [36].…”

Section: Main Issuementioning

confidence: 99%

Evaluation of Pregnancy and Thyroid Function

Chang-Eun

2018

Korean J Clin Lab Sci.

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임신과 갑상선 기능의 평가 박창은 남서울대학교 임상병리학과, 분자진단연구소During early pregnancy, before the development of a functioning thyroid gland, thyroid stimulating hormone (TSH) is a very sensitive marker of thyroid dysfunction during pregnancy. Normal values have been modified during gestation with a downward shift. The fetus is influenced by the TSH supplied by the mother. TSH and free thyroxine (FT4) concentrations vary during pregnancy and conventional units can vary between laboratories. A downward shift of the TSH reference range occurs during pregnancy, with a decrease in both the lower and upper limits of maternal TSH, relative to the typical non-pregnant TSH reference range. Each laboratory produces its own reference TSH and FT4 concentrations because there are many different assays that yield different results in pregnancy. Therefore, automated immunoassays used for serum FT4 analysis are still used widely, but the important considerations discussed above must be noted. The use of population-based, trimester-specific reference ranges remains the best way to handle this issue The slight downward shift in the upper reference range of TSH occurring in the latter first trimester (7∼12 weeks) of pregnancy, typically not observed prior to 7 weeks. Their use indicates high or low levels in a quantitative manner independent of the reference ranges. These data highlight the importance of calculating population-based pregnancy-specific thyroid parameter reference intervals. A precision medicine initiative in this area will require the collection and analysis of a large number of genetic, biological, psychosocial, and environmental variables in large cohorts of individuals. Large prospective randomized controlled trials will be needed to resolve these controversies.

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Maternal thyroid parameters, body mass index and subsequent weight gain during pregnancy in healthy euthyroid women

Abstract: Maternal thyroid parameters are related to both prepregnancy BMI and weight gain throughout gestation.

Cited by 54 publications

References 21 publications

Thyroid Function in Pregnancy: What Is Normal?

Thyroid Function in Pregnancy: What Is Normal?

MANAGEMENT OF ENDOCRINE DISEASE: Isolated maternal hypothyroxinemia during pregnancy: knowns and unknowns

Evaluation of Pregnancy and Thyroid Function

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