Predictive Value of the TSH/FT4 Ratio in Women with Suspected PE or GH

Abstract

Objective: In the present study, we aimed to examine whether the TSH/FT4 ratio after the second trimester can predict the prevalence of preeclampsia (PE) or gestational hypertension (GH). Study design:Retrospective case-control study. Methods:We collected TSH and FT4 serum levels after the second trimester in 133 pregnant women with suspected PE or GH. Participants were divided into 2 groups, the PE+GH group and the non-PE+GH group and conducted the retrospective study for the two groups to evaluate the background and the prevalence of PE or GH were retrospectively evaluated.Results: Among the participants in the PE+GH group, mean age, body mass index (BMI) at no pregnancy and BMI at delivery were 34.5 ± 6.7 years, 22.3 ± 3.9 kg/m 2 and 26.0 ± 4.0 kg/m 2 , respectively. Among the participants in the non-PE+GH group, mean age, BMI at no pregnancy and BMI at delivery were 32.9 ± 5.5 years, 22.5 ± 4.8 kg/m 2 and 26.1 ± 4.4 kg/m 2 , respectively. There were no significant differences observed between the two groups. The cutoff point of the TSH/FT4 ratio was 1.9 (sensitivity 0.45, specificity 0.81), which was derived from the receiver operating characteristic curve. The adjusted odds ratio of PE or GH prevalence was 3.60 (95% CI: 1.62-8.02). Conclusion:The TSH/FT4 ratio after the second trimester may aid in the prediction of PE or GH prevalence.ratio, may be associated with the prevalence of PE or gestational hypertension (GH) and examined whether TSH/FT4 ratio could be measured more easily than the sFlt-1/PlGF ratio. MethodsThis matched case-control study was conducted between April 2014 and March 2016 at the Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka City, Japan.Our hospital is located in the Miyakojima Ward of Osaka City. The population of Miyakojima Ward is approximately 104,000, with the birth of approximately 870 infants each year. Our hospital has 1063 beds and fulfills the role of a perinatal medical center. The maternal-fetal intensive care unit (MFICU) consists of 6 beds, the neonatal intensive care unit (NICU) 12 beds and the growing care unit (GCU) 18 beds.A total of 1810 singleton pregnancies delivered at our hospital were enrolled: 270 of them had suspected PE or GH or were diagnosed with PE at the last pregnancy. The analysis included 133 eligible pregnancies in which TSH and FT4 could be measured after the second trimester ( Figure 1).We divided the participants into 2 groups: 1 group with PE or GH (PE+GH group) and 1 group without PE or GH (non-PE+GH group). IntroductionPreeclampsia (PE) is considered to be caused by a vascular endothelial cell disorder and has recently been associated with soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF).The disorder results from abnormal maternal spiral artery remodeling [1].In normal pregnancy, trophoblastic cells penetrate the decidua as well as the alternate vascular endothelial cells or vascular muscles of the maternal spiral arteries, resulting in maternal spiral artery remodelling [2]. In...