Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia

Avramovska, Maja; Milevska-Kostova, Neda; Karanfilski, B; Hunziker, Sandra; Vaskova, Olivija; Dimitrov, Goran; Dzikova, Elena; Markova, Ana Daneva; Lega, Marija Hadzi; Tofoski, Gligor; Šikole, Aleksandar

doi:10.1055/s-0041-1736172

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…Of 202 records retrieved through searching databases, 11 studies were included, and all of them had a cohort de-sign (2,3,9,12,(22)(23)(24)(36)(37)(38)(39). Table 1 summarizes the characteristics of the studies included.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

Maternal Subclinical Hyperthyroidism and Adverse Pregnancy Outcomes: A Systematic Review and Meta-analysis of Observational Studies

Nazarpour

Amiri

Azizi

et al. 2022

Int J Endocrinol Metab

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Context: Findings from studies evaluating adverse pregnancy outcomes in pregnant women with subclinical hyperthyroidism are conflicting and inconclusive. Objectives: In this systematic review and meta-analysis, our aim was to evaluatethe pooled odds ratio (OR) of adverse pregnancy outcomes in women with subclinical hyperthyroidism, compared to euthyroid women. Data Sources: Scopus, PubMed (including Medline), and Web of Science databases were systemically searched for regaining published studies to January 2022 examining adverse pregnancy outcomes in women with subclinical hyperthyroidism. Study Selection: Outcomes of interest were classified into seven composite outcomes, including hypertensive disorders, preterm delivery, macrosomia/large for gestational age (LGA), pregnancy loss, adverse maternal outcomes, adverse neonatal outcomes, and adverse fetal outcomes. Data Extraction: In this meta-analysis, both fixed and random effect models were used. Publication bias was also evaluated by Egger test and the funnel plot, and the trim and fill method was conducted in case of a significant result, to adjust the bias. Results: Of 202 records retrieved through searching databases, 11 studies were selected for the final analyses. There were no significant differences in pooled ORs of hypertensive disorders, preterm delivery, macrosomia/LGA, and pregnancy loss in pregnant women with subclinical hyperthyroidism, compared to the euthyroid controls. The pooled OR of adverse maternal, neonatal, and fetal outcomes in pregnant women with subclinical hyperthyroidism was not statistically significantly different from that of the euthyroid control group. Conclusions: The current meta-analysis demonstrated that subclinical hyperthyroidism in pregnancy is not related with adverse maternal and fetal outcomes. Therefore, clinicians should be avoided unnecessary treatments for pregnant women with subclinical hyperthyroidism.

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Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

Maternal Subclinical Hyperthyroidism and Adverse Pregnancy Outcomes: A Systematic Review and Meta-analysis of Observational Studies

Nazarpour

Amiri

Azizi

et al. 2022

Int J Endocrinol Metab

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“…Similarly, maintaining adequate iodine nutrition and thyroid function during pregnancy is also critical for perinatal outcomes. A study carried out in North Macedonia showed total serum thyroxine (TT4) had a statistically significant inverse predictive impact on low birth weight, and thyroglobulin (Tg) had a positive impact on low birth weight (8). A study in Australia showed no correlation between iodine intake and their neonates' TSH (9).…”

Section: Introductionmentioning

confidence: 99%

Iodine nutritional status and its associations with thyroid function of pregnant women and neonatal TSH

Fan,

Bu,

Chen

et al. 2024

Front. Endocrinol.

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IntroductionIodine serves as a crucial precursor for the synthesis of thyroid hormones and plays an import role in both pregnant women and their offspring. The relationships between iodine nutritional status and maternal thyroid function and neonatal outcomes remain inconclusive in areas with adequate iodine nutrition. This study aims to investigate their correlations.MethodsBlood, morning urine and 24-hour urine were collected from the pregnant women to measure thyroid functions, serum iodine concentration (SIC), morning urine iodine concentration (UIC) and 24-hour urine iodine excretion (24-hour UIE). Indicators of their offspring’s neonatal indexes were recorded.ResultsA total of 559 pregnant women were enrolled in this study. The iodine indicators including Tg, 24-hour UIE and morning UIC were significantly different among the euthyroid pregnant women and those with different thyroid disorders. The levels of FT3, FT4, and SIC exhibited a gradual decline and the concentration of TSH exhibited a gradual increase trend throughout the progression of pregnancy in euthyroid pregnant women. There were no significant differences in neonatal outcomes and neonatal TSH values among euthyroid pregnant women and thyroid disorders pregnant women. SIC had a significant impact on maternal FT4 levels throughout all three trimesters, with varying degrees of importance observed in each trimester. TSH level emerged as the primary determinant of FT4 during the first trimester, while SIC exerted a predominant influence on FT4 levels in the second and third trimesters. The prevalence of thyroid disorders in pregnant women was the lowest when the SIC of pregnant women was probable in the range of 60~70 μg/L, 24-hours UIE was in the range of 250~450 μg, and Tg was in the range of 9~21 μg/L. Maternal TSH exhibited a notable influence on neonatal TSH levels, particularly at the 50th and 75th quantiles. Among the iodine nutritional indicators, SIC and morning UIC demonstrated higher AUC values for abnormal FT4 and TSH, respectively.DiscussionThe iodine nutrition status of pregnant women exerts an impact on their thyroid function and prevalence of thyroid disorders, and neonatal TSH was affected by maternal TSH. SIC may be a better indicator for iodine nutritional assessment than other indexes.

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Thyroid Function of Pregnant Women and Perinatal Outcomes in North Macedonia

Cited by 2 publications

References 19 publications

Maternal Subclinical Hyperthyroidism and Adverse Pregnancy Outcomes: A Systematic Review and Meta-analysis of Observational Studies

Maternal Subclinical Hyperthyroidism and Adverse Pregnancy Outcomes: A Systematic Review and Meta-analysis of Observational Studies

Iodine nutritional status and its associations with thyroid function of pregnant women and neonatal TSH

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