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Maternal Thyroid Hypofunction and Pregnancy Outcome
- Source :
- Obstetric Anesthesia Digest. 29:92
- Publication Year :
- 2009
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2009.
-
Abstract
- To estimate whether maternal thyroid hypofunction is associated with complications.A total of 10,990 patients had first- and second-trimester serum assayed for thyroid-stimulating hormone (TSH), free thyroxine (freeT4), and antithyroglobulin and antithyroid peroxidase antibodies. Thyroid hypofunction was defined as 1) subclinical hypothyroidism: TSH levels above the 97.5th percentile and free T4 between the 2.5th and 97.5th percentiles or 2) hypothyroxinemia: TSH between the 2.5th and 97.5th percentiles and free T4 below the 2.5th percentile. Adverse outcomes were evaluated. Patients with thyroid hypofunction were compared with euthyroid patients (TSH and free T4 between the 2.5th and 97.5th percentiles). Patients with and without antibodies were compared. Multivariable logistic regression analysis adjusted for confounders was used.Subclinical hypothyroidism was documented in 2.2% (240 of 10,990) in the first and 2.2% (243 of 10,990) in the second trimester. Hypothyroxinemia was documented in 2.1% (232 of 10,990) in the first and 2.3% (247 of 10,990) in the second trimester. Subclinical hypothyroidism was not associated with adverse outcomes. In the first trimester, hypothyroxinemia was associated with preterm labor (adjusted odds ratio [aOR] 1.62; 95% confidence interval [CI] 1.00-2.62) and macrosomia (aOR 1.97; 95% CI 1.37-2.83). In the second trimester, it was associated with gestational diabetes (aOR 1.7; 95% CI 1.02-2.84). Fifteen percent (1,585 of 10,990) in the first and 14% (1,491 of 10,990) in the second trimester had antithyroid antibodies. When both antibodies were positive in either trimester, there was an increased risk for preterm premature rupture of membranes (P=.002 and P.001, respectively).Maternal thyroid hypofunction is not associated with a consistent pattern of adverse outcomes.II.
- Subjects :
- Adult
Risk
endocrine system
Fetal Membranes, Premature Rupture
medicine.medical_specialty
endocrine system diseases
medicine.medical_treatment
Thyroid Function Tests
Thyroid function tests
Thyroglobulin
Outcome (game theory)
Article
Thyroid disease in pregnancy
Hypothyroidism
Thyroid peroxidase
Pregnancy
Internal medicine
Odds Ratio
medicine
Humans
Autoantibodies
medicine.diagnostic_test
biology
Obstetrics
business.industry
Thyroid
Pregnancy Outcome
Obstetrics and Gynecology
medicine.disease
Pregnancy Complications
Pregnancy Trimester, First
Endocrinology
medicine.anatomical_structure
Pregnancy Trimester, Second
biology.protein
Gestation
Female
business
Hormone
Subjects
Details
- ISSN :
- 0275665X
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Obstetric Anesthesia Digest
- Accession number :
- edsair.doi.dedup.....0aff546ad7ba415a4a8e87780f1746c7