Prevalence of thyroid dysfunction and thyroid antibodies in a private obstetrical practice in Sydney

Blumenthal, Norman J.; Eastman, Creswell J

doi:10.1111/ajo.12462

Cited by 11 publications

(12 citation statements)

References 27 publications

(47 reference statements)

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“…Furthermore, we need to consider the effect of autoimmunity on thyroid function because 16% of pregnant women with eTSH had TSH antibodies according to our study. The prevalence of positive thyroid antibodies is low compared to that of Australian pregnant women with SCH (41-67%) (Blumenthal et al 2016). Consequently, SCH in Japan might be caused by iodine excess.…”

Section: Discussionmentioning

confidence: 90%

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Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Furukawa

Miyakawa

Shibata

et al. 2017

Tohoku J. Exp. Med.

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Maternal subclinical hypothyroidism may be associated with adverse pregnancy outcomes, although not consistently across regions. Here, we sought to determine the effect of elevated thyroid-stimulating hormone (TSH) on pregnancy outcomes in Japanese women without known medical complications. TSH was determined by dried blood spots at 8-20 weeks of gestation, and 3.0-10.0 μ U/mL of TSH was considered as elevated TSH (eTSH). A retrospective study involving 167 cases of eTSH was conducted. Five hundred and seventy eight of controls with normal TSH and without thyroid antibodies were selected. We compared a composite adverse maternal outcome comprised of spontaneous abortion, premature delivery, gestational diabetes mellitus (GDM), placental abruption, and pregnancy-induced hypertension, as well as composite adverse neonatal outcome including stillbirths, heavy for date, light for date, and a low Apgar score (< 7) at 5 minutes between two groups. The incidence of GDM was significantly higher in eTSH (p < 0.01); however, composite adverse maternal and neonatal outcome did not differ between groups (p = 0.19 and p = 0.50, respectively). Although 27 out of 167 cases in eTSH have antibodies, composite adverse outcome did not differ between eTSH with antibodies and controls (p = 0.64 and p = 0.50, respectively). Additionally, composite adverse maternal and neonatal outcome did not differ between the group larger than the median of TSH in eTSH (n = 81) and controls (p = 0.43 and p = 0.98, respectively). Thus, elevated TSH is not associated with overall adverse pregnancy outcomes in women without known medical complications.

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Section: Discussionmentioning

confidence: 90%

“…iodine deficiency with a high prevalence of thyroid autoimmunity (Stagnaro-Green et al 1990;Andersson et al 2012;Blumenthal et al 2016). The synergistic effect of iodine deficiency and autoimmunity may have a substantial influence on maternal and fetal outcome.…”

Section: Discussionmentioning

confidence: 99%

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Furukawa

Miyakawa

Shibata

et al. 2017

Tohoku J. Exp. Med.

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“…To sum up, in previous studies, autoimmunity and iodine intake were claimed to be the main underlying mechanisms for adverse pregnancy outcomes . In studies that were performed in China and Japan, antibody positivity and iodine excess were found to be main reasons, whereas the main cause in overseas is reported to be iodine deficiency and high prevalence of antibodies . In our country, it was shown that even with salt iodinization in pregnancy, pregnancies are prone to be faced with some degree of iodine deficiency .…”

Section: Discussionmentioning

confidence: 75%

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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“…If prospective trials find that treating subclinical hypothyroidism in pregnancy is beneficial, this would support universal screening in future. 22 …”

Section: Antithyroid Therapymentioning

confidence: 99%

Thyroid disorders in pregnancy and postpartum

Smith¹,

Eccles-Smith²,

d’Emden³

et al. 2017

Aust Prescr

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Prevalence of thyroid dysfunction and thyroid antibodies in a private obstetrical practice in Sydney

Cited by 11 publications

References 27 publications

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Women with Subclinical Hypothyroidism Are at Low Risk of Poor Pregnancy Outcome in Japan

Pregnancy outcomes of antibody negative and untreated subclinical hypothyroidism

Thyroid disorders in pregnancy and postpartum

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