Pregnancy-induced alterations in mitochondrial function in euthyroid pregnant women and pregnant women with subclinical hypothyroidism; relation to adverse outcome

Feldthusen, Anne-Dorthe; Larsen, Jacob; Pedersen, Palle; Kristensen, Tina Toft; Kvetny, Jan

doi:10.1016/j.jcte.2013.12.003

Cited by 21 publications

(25 citation statements)

References 26 publications

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“…Multiple studies have reported an association of SCH with an increase in the risk of adverse pregnancy and neonatal outcomes, including pregnancy loss, preterm delivery, gestational diabetes, gestational hypertension, preeclampsia, placental abruption, premature rupture of membranes, intrauterine growth restriction, low birth weight, small for gestational age, low Apgar score, and neonatal death (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Furthermore, high TSH levels in women during pregnancy have been associated with an increased risk of neurocognitive deficits in the offspring (17).…”

mentioning

confidence: 99%

Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis

Maraka

Ospina

O’Keeffe

et al. 2016

Thyroid

315

210

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Background: The impact of subclinical hypothyroidism (SCH) and of levothyroxine replacement in pregnant women with SCH is unclear. The aims of this study were to assess (i) the impact of SCH during pregnancy on maternal and neonatal outcomes, and (ii) the effect of levothyroxine replacement therapy in these patients. Methods: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, the Cochrane Controlled Trials Register, Ovid EMBASE, Web of Science, and Scopus were searched from inception to January 2015. Randomized trials and cohort studies of pregnant women with SCH that examined adverse pregnancy and neonatal outcomes were included. Reviewers extracted data and assessed methodological quality in duplicate. Eighteen cohort studies at low-to-moderate risk of bias were included. Compared with euthyroid pregnant women, pregnant women with SCH were at higher risk for pregnancy loss (relative risk [RR] . One study at high risk of bias compared pregnant women with SCH who received levothyroxine to those who did not and found no significant decrease in the rate of pregnancy loss, preterm delivery, gestational hypertension, low birth weight, or low Apgar score. Conclusions: SCH during pregnancy is associated with multiple adverse maternal and neonatal outcomes. The value of levothyroxine therapy in preventing these adverse outcomes remains uncertain.

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mentioning

confidence: 99%

Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis

Maraka

Ospina

O’Keeffe

et al. 2016

Thyroid

315

210

View full text Add to dashboard Cite

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“…The association between SCH and pregnancy outcomes is controversial. Although many studies have reported a relationship between SCH and these outcomes, there are still many missing pieces of the puzzle about this issue …”

Section: Discussionmentioning

confidence: 82%

“…Although many studies have reported a relationship between SCH and these outcomes, there are still many missing pieces of the puzzle about this issue. 1,21,23 Pregnancy loss is a common complication of pregnancy but the increment rate of miscarriage in SCH patients remains unclear. Su et al reported no correlation between SCH and miscarriage, whereas Liu et al and Negro et al revealed higher miscarriage risk in SCH.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes of antibody negative and untreated subclinical hypothyroidism

Çakmak

Türker

Temür

et al. 2019

J of Obstet and Gynaecol

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Aim Subclinical hypothyroidism is thought to be associated with adverse pregnancy outcomes but the data is conflicting and generally depends on antibody positivity and treatment. We evaluated the pregnancy outcomes in Turkish population with untreated, antibody negative subclinical hypothyroidism for the first time. Methods We searched for 30 015 patients between January 2016 and May 2017 retrospectively. Finally, a total of 930 pregnant women with untreated, antibody negative subclinical hypothyroidism and 7986 controls were included. Demographic characteristics, laboratory findings and pregnancy outcomes, including pregnancy loss, impaired glucose tolerance, gestational diabetes, hypertensive disorders of pregnancy, preterm birth, neonatal intensive care unit admission, placenta previa and abruption, cesarean delivery, low birthweight, Apgar score <7 and premature rupture of membranes were recorded. Results Demographic and laboratory characteristics were similar between two groups except thyroid stimulating hormone levels and previous uterine surgery rates. Subclinical hypothyroidism group had an increased risk of pregnancy loss (odds ratio [OR] 2.583; 95% confidence interval [CI] 1.982–3.365; P < 0.001), impaired glucose tolerance (OR 1.952; 95% CI 1.450–2.627; P < 0.001), hypertensive disorders of pregnancy (OR 1.476; 95% CI 1.113–1.923; P = 0.004), neonatal intensive care unit admission (OR 1.620; 95% CI 1.084–2.420; P = 0.019), placenta previa (OR 12.581; 95% CI 5.046–31.363; P < 0.001) and cesarean delivery (OR 1.263; 95% CI 1.091–1.462; P = 0.002). Conclusion Subclinical hypothyroidism has worse pregnancy outcomes as compared to euthyroid pregnant women even in antibody negativity. Therefore, we suggest that all pregnant women should routinely be screened in their first antenatal visits for thyroid functions.

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“…(Table 1 Among all women, 38.5% were primigravida and 61.5% were multigravida. [7][8][9][10] .In the American study with samples from over half a million pregnant women, there were significant differences in the prevalence of hypothyroid disorders among Asian American women (19.3%) compared to African Americans (6.7%) and Caucasians (16.4%). 8 Dhanwal et al 4 from Delhi in 2013 reported a hypothyroidism prevalence of 14.3%, with a cut-off of 4.5 mIU/L as upper limit of normal in a cohort of 1000 pregnant women.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of subclinical hypothyroidism in North-Indian pregnant women

Goel

Sharma

Agrawal

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONSubclinical hypothyroidism (SCH) in pregnancy is defined by a serum thyroid-stimulating hormone (TSH) concentration higher than the upper limit of the pregnancy related reference range associated with a normal serum thyroxine [T 4; either total (TT 4) or free (FT 4 )] concentration.The prevalence of hypothyroidism during pregnancy is estimated to be 0.3-0.5% for overt hypothyroidism (OH) and 2-3% for subclinical hypothyroidism (SCH).1 There are few reports of prevalence of hypothyroidism during pregnancy from India with prevalence rates ranging from 4.8% to 14.3%. [2][3][4] It is now well established that not only overt but subclinical thyroid dysfunction can also have adverse effects on fetal and maternal outcome. Current data indicate an increase in pregnancy loss, gestational diabetes, gestational hypertension, pre-eclampsia and preterm delivery in women with SCH in pregnancy. The association between SCH in pregnancy and impaired neuropsychological development of the offspring is inconsistent.Many of these adverse effects could be prevented or ameliorated by early detection and appropriate treatment. ABSTRACT Background:It is now well established that not only overt but subclinical thyroid dysfunction can also have adverse effects on fetal and maternal outcomes. In recent years several studies show a much larger prevalence of SCH and marked variation between different ethnic groups. The aim of this study was to find out the prevalence of subclinical hypothyroidism during first trimester in a teaching hospital in North India. Methods: A prospective observational study was conducted in all the consecutive first trimester pregnant women attending Santosh Medical College, Hospital, Ghaziabad from June 2014 to April 2015 after institutional ethics approval and consent from the study subjects. Morning samples of serum were tested for TSH. If serum TSH value was more than 2.5mIU/L then Free T4 and TPO Antibody level were estimated. Results: Serum TSH level was normal in 66.2 % women, 32.5 % women had subclinical hypothyroidism and 1.3 % women had overt hypothyroidism using a first trimester normal reference range of 0.1 to 2.5 mU/l suggested by American Thyroid Association or by the American Endocrine Society. Using 5 mIU/L as upper limit of TSH suggested by some Indian studies serum TSH level was normal in 90.6 % women, 8.1 % women had subclinical hypothyroidism and 1.3 % women had overt hypothyroidism. Conclusion:The prevalence of SCH is very high in our study population. We feel that the use of thyroid function reference values based on studies using different populations and different backgrounds can introduce bias in the evaluation of a local population.

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Pregnancy-induced alterations in mitochondrial function in euthyroid pregnant women and pregnant women with subclinical hypothyroidism; relation to adverse outcome

Cited by 21 publications

References 26 publications

Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis

Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis

Pregnancy outcomes of antibody negative and untreated subclinical hypothyroidism

Prevalence of subclinical hypothyroidism in North-Indian pregnant women

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