Preconception thyroid‐stimulating hormone levels and adverse pregnancy outcomes

Li, Min; He, Yang; Mao, Yanyan; Yang, Liu; Chen, Liang; Du, Jing; Chen, Qing; Zhu, Qianxi; Zhou, Weijin

doi:10.1111/cen.14668

Cited by 9 publications

(6 citation statements)

References 35 publications

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“…Формированию обладаю щих высокой степенью достоверности выводов о роли заболеваний щитовидной железы в патогенезе преждевременных родов препятствует имеющий место во всех развитых странах неполный охват женщин скринингом уровня ТТГ при ведении беременности, на что нами указывалось выше. Как показано в недавних исследованиях, почти 20% пациентов не подвергается измерению уровня ТТГ во время беременности [11].…”

Section: Discussionunclassified

“…Впрочем, получены и объективные данные о том, что риск неблагоприятных исходов беременности, вклю-чая преждевременные роды, ассоциируется с субклиническим гипотиреозом, имевшим место до зачатия, поскольку низкие резервы щитовидной железы не могут удовлетворить возросшую потребность в тироксине [11].…”

Section: Introductionunclassified

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Pregnancy outcomes and thyroid dysfunction: preterm birth risk assessment

et al. 2022

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Introduction. Subclinical hypothyroidism occurs in 2–3% of pregnant women and is often associated with pregnancy complications, including preterm birth.Aim – to study correlations between thyroid dysfunction and pregnancy outcomes.Materials and methods. 64 clinical cases of managing pregnant women in the Perinatal Center (Tyumen) were analyzed for 2017– 2021: 28 women with thyroid-stimulating hormone (TSH) > 2.5 mU/l, 36 women with TSH ≤ 2.5 mU/l) during the entire period of pregnancy. Quantitative features are described by absolute and relative (percentage) indicators. The probability of outcome depending on the presence of a clinical-amnestic factor was assessed by determining the relative risk (RR) and 95% confidence interval (CI). The level of statistical significance in testing the null hypothesis is p < 0.05.Results. There were no differences in pregnant women with and without subclinical hypothyroidism when considering such medical and social factors as age, marital status, work, education, nicotine addiction, obesity, kidney disease. An increased risk of preterm delivery was found in patients with a TSH level > 2.5 mU/l: RR 1.41 (0.59–3.37), especially against the background of a positive test for antibodies to thyroperoxidase: RR 1.63 (0.62–4.28). In the absence of treatment, the risk of early delivery, preterm birth, preeclampsia was revealed.Conclusions. A universal approach to determining the threshold values of TSH for the diagnosis of subclinical hypothyroidism in pregnant women, to the need and tactics of its treatment has not been developed. Diseases of the thyroid gland are endemic for Western Siberia, often associated with iron deficiency anemia, their high frequency in the anamnesis of pregnant women is noted. Establishing a correlation between subclinical hypothyroidism, hormonal correction and pregnancy complications requires further research. An obstacle is the lack of proper diagnosis of the TSH level in women who give birth on an emergency basis in early gestational periods.

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Section: Discussionunclassified

Section: Introductionunclassified

Pregnancy outcomes and thyroid dysfunction: preterm birth risk assessment

et al. 2022

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“…Maternal biochemical hypothyroidism is usually a priori defined as TSH above 6.0 mIU/L, and exposure to TSH above 10 mIU/L is used as a marker of overt maternal hypothyroidism. It is known that subclinical thyroid dysfunction before conception is related to an increased risk of adverse pregnancy outcomes [26], which significantly occur in pregnant women having TSH above 10 mIU/L. Interestingly, no significant association between thyroid autoantibodies and pregnancy outcomes was found in recent research by Knøsgaard et al [27].…”

Section: The Delicate Thyroid Equilibrium In Pregnancymentioning

confidence: 97%

Innate Immunity in Autoimmune Thyroid Disease during Pregnancy

Bogović Crnčić,

Girotto,

Ilić Tomaš

et al. 2023

IJMS

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Autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disorder clinically presented as Hashimoto thyroiditis (HT) and Graves’ disease (GD). The pathogenesis of AITD is caused by an inappropriate immune response related to genetic, non-genetic, and environmental factors. Pregnancy is one of the factors that have a great influence on the function of the thyroid gland because of the increased metabolic demand and the effects of hormones related to pregnancy. During pregnancy, an adaptation of the maternal immune system occurs, especially of the innate immune system engaged in maintaining adaptive immunity in the tolerant state, preventing the rejection of the fetus. Pregnancy-related hormonal changes (estrogen, progesterone, hCG) may modulate the activity of innate immune cells, potentially worsening the course of AITD during pregnancy. This especially applies to NK cells, which are associated with exacerbation of HD and GD. On the other hand, previous thyroid disorders can affect fertility and cause adverse outcomes of pregnancy, such as placental abruption, spontaneous abortion, and premature delivery. Additionally, it can cause fetal growth retardation and may contribute to impaired neuropsychological development of the fetus. Therefore, maintaining the thyroid equilibrium in women of reproductive age and in pregnant women is of the highest importance.

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“…In addition to hyperglycemia, abnormal thyroid function is more common during the preconception period. Maternal hypothyroidism is related to preterm birth and impaired neurodevelopmental function (78)(79)(80)(81)(82). Sufficient thyroid hormone levels are essential for fetal growth, especially brain development, and timely medication should be initiated and continuously monitored during pregnancy.…”

Section: Pre-existing Medical Conditionsmentioning

confidence: 99%

Nationwide-free preconception care strategy: Experience from China

Zhou

2022

Front. Public Health

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Preconception care has emerged as a developing field in maternal and child healthcare worldwide. This care type provides couples of reproductive age with the opportunity for early detection and management of biomedical, behavioral, and social health problems. In 2010, the Chinese government launched a nationwide preconception care program as a welfare project. During the past decade, this project has received international attention, and experiences from the project have been published in the literature. In this review, we summarize the history, implementation, and evaluation of preconception care services in China, and its related maternal and children's health service initiatives, to thereby provide knowledge for policymakers and clinicians in other countries.

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Preconception thyroid‐stimulating hormone levels and adverse pregnancy outcomes

Cited by 9 publications

References 35 publications

Pregnancy outcomes and thyroid dysfunction: preterm birth risk assessment

Pregnancy outcomes and thyroid dysfunction: preterm birth risk assessment

Innate Immunity in Autoimmune Thyroid Disease during Pregnancy

Nationwide-free preconception care strategy: Experience from China

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