Pregnancy outcomes of antibody negative and untreated subclinical hypothyroidism

Çakmak, Burcu Dinçgez; Türker, Ülkü Ayşe; Temür, Muzaffer; Üstünyurt, Emin

doi:10.1111/jog.13925

Cited by 21 publications

(13 citation statements)

References 32 publications

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“…In addition to SCH, multiple factors including hormonal disorders, imbalances of angiogenic factors, and placental hypoxia also contribute to high blood pressure (24). In women with SCH, the mechanism for HDP may be based on decreased nitric oxide secretion and impairment of vasodilation in endothelial tissues (25). Hypercoagulability, increments in blood viscosity, and lipid abnormalities in patients with SCH potentially increase the risk for atherosclerosis; the increase of blood pressure in SCH may be related to these factors (26).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Subclinical Hypothyroidism on Adverse Perinatal Outcomes and the Role of Thyroid Screening in Pregnancy

Liu

Wang

et al. 2019

Front. Endocrinol.

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Subclinical hypothyroidism (SCH) is a mild form of hypothyroidism that is common among women of childbearing age. The impact of SCH on adverse perinatal outcomes is unclear and universal screening for thyroid function before or during pregnancy is also much debated. In the present retrospective cohort study on 7,587 women from Shanghai, we assessed whether SCH was associated with adverse perinatal outcomes. The relationship between the risks of adverse outcomes and the time of screening and LT4 treatment status for SCH were also evaluated. SCH was associated with hypertensive disorders of pregnancy (HDP) [odds ratio (OR): 4.04; 95% confidence interval (CI): 1.85–8.84; P = 0.000]. After classification into four different groups based on the time of screening for thyroid function, the increased likelihood of HDP persisted in those diagnosed with SCH in the first and second trimesters (OR: 9.69; 95% CI: 1.73–54.48; P = 0.01 and OR: 3.66; 95% CI: 1.07–12.57, P = 0.03, respectively). The diagnosis of SCH in the preconception period and the third trimester was not significantly associated with HDP and other adverse perinatal outcomes. Five out of 120 (5/120) treated women (4.17%) vs. 4/45 untreated women (8.89%) developed HDP, 4/5 were treated after conception. The results indicate that during pregnancy, SCH conferred an increased risk of HDP, particularly in women diagnosed with the disorder in the first and second trimesters.

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Section: Discussionmentioning

confidence: 99%

The Impact of Subclinical Hypothyroidism on Adverse Perinatal Outcomes and the Role of Thyroid Screening in Pregnancy

Liu

Wang

et al. 2019

Front. Endocrinol.

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“…It is stated that there is no sufficient evidence whether a universal screening should be recommended for TSH concentrations before pregnancy, but they have made an exception for women planning assisted reproduction techniques and those determined positive ATA. However, a recent large-scaled retrospective cohort study showed that the worse pregnancy outcomes were determined in subclinical hypothyroidism compared to euthyroid pregnancies even in antibody negativity [33].…”

Section: Discussionmentioning

confidence: 98%

The impact of thyroid autoantibodies on the cycle outcome and embryo quality in women undergoing intracytoplasmic sperm injection

Tokgöz

Isim

Tekin

2020

Middle East Fertil Soc J

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Background: The influence of thyroid autoimmunity in in-vitro fertilization/intracytoplasmic sperm injection (ICSI) cycles is still a controversial issue. Although some women are euthyroid, some studies found thyroid dysfunction and thyroid autoimmunity increased the incidence of infertility. We aimed to evaluate the impact of anti-thyroid antibodies on the cycle parameters, embryo quality, and pregnancy outcomes in women who underwent ICSI cycles. Results: Fertilization rate was significantly higher in anti-thyroid antibody-negative patients than in anti-thyroid antibody-positive patients (97.1 ± 10.5 vs. 91.5 ± 19.8, respectively, p = 0.003). Clinical pregnancy, miscarriage, and ongoing pregnancy rates were not different among study groups. The presence of top-quality embryo was lower in anti-thyroid antibody-positive patients but it did not reach any statistical significance (56.5% vs. 67.8%, p = 0.09). In the subgroup analysis, there were no significant differences except for the miscarriage rate according to the TSH threshold. Conclusion: The clinical pregnancy and ongoing pregnancy were not affected by the positivity of anti-thyroid antibodies. We showed that thyroid autoimmunity may have an impact on fertilization rate and embryo quality in patients undergoing ICSI cycles. Miscarriage rate also increases with thyroid autoimmunity and TSH levels above 2.5 μIU/L.

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“…In this study, there were no significant differences in the incidence of GDM, PROM, HDP, preterm birth, fetal distress, low birth weight, fetal macrosomia, and SGA between the hypertension, but does not increase the incidence of GDM, intrahepatic cholestasis in pregnancy, PROM, fetal growth restriction, and preterm delivery. A retrospective study (8) revealed that thyroid autoantibody-negative SCH increased the risk of miscarriage, abnormal GS tolerance, HDP, and placenta previa. A meta-analysis( 23) involving SCH and GDM showed that SCH with positive antithyroid autoantibodies in pregnancy is associated with an increased risk of GDM.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown that SCH with TAI increases the risk of miscarriage, preterm birth, and GDM (6,7). Nevertheless, a previous retrospective study (8) involving 3,015 pregnant women revealed that untreated thyroid autoantibody-negative SCH increased the risk of miscarriage, abnormal blood glucose (GS) tolerance, placenta previa, and placental abnormality. A meta-analysis (9) confirmed that SCH is a risk factor for miscarriage and found that early treatment can reduce the rate of miscarriage.…”

Section: Introductionmentioning

confidence: 99%

Untreated thyroid autoantibody-negative SCH increases the risk of spontaneous abortions

Yuan

Sun

Zhao

et al. 2022

Endocrine Connections

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Background: Numerous studies have found that subclinical hypothyroidism (SCH) may increase the adverse pregnancy outcomes; however, the benefit of levothyroxine (LT4) treatment remains controversial.Therefore, the primary goal of this study was to investigate the correlation between thyroid autoantibodies negative-SCH with or without LT4 treatment and adverse pregnancy outcomes. Methods: 1344 women involved the study according the inclusion and exclusion criteria. Assays for thyroid stimulating hormone (TSH), free thyroxine (FT4), anti-thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TGAb) and laboratory indicators were performed. The participants were divided into the euthyroid group (n = 1250) and the SCH group(n=94). The SCH group was further divided into LT4 group (n =40) and non-LT4 group(n=54). The laboratory indicators and pregnancy outcomes were evaluated during follow-ups. Results: There were no significant differences in lipid profile and homocysteine levels between ET and SCH group in the first and third trimester of pregnancy (P<0.05). After adjusting the confounding factors, the non-LT4 group was a risk factor for spontaneous abortion (OR: 3.141, 95% CI: 1.060-9.302). Survival analysis showed that the time of abortion was different between the ET group and SCH group (Log-rank P=0.042). The spontaneous abortion of SCH, especially non-LT4 group mainly occurred in the first trimester of pregnancy. Conclusions: Thyroid autoantibody negative-SCH seems to be associated with increased risk of spontaneous abortions during first trimester of pregnancy. LT4 therapy in this patient population might be beneficial to reduce adverse pregnancy outcomes.

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Pregnancy outcomes of antibody negative and untreated subclinical hypothyroidism

Cited by 21 publications

References 32 publications

The Impact of Subclinical Hypothyroidism on Adverse Perinatal Outcomes and the Role of Thyroid Screening in Pregnancy

The Impact of Subclinical Hypothyroidism on Adverse Perinatal Outcomes and the Role of Thyroid Screening in Pregnancy

The impact of thyroid autoantibodies on the cycle outcome and embryo quality in women undergoing intracytoplasmic sperm injection

Untreated thyroid autoantibody-negative SCH increases the risk of spontaneous abortions

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