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Thyroid-stimulating hormone, anti–thyroid antibodies, and pregnancy outcomes
- Source :
- American Journal of Obstetrics and Gynecology. 217:697.e1-697.e7
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Background Overt thyroid dysfunction has been associated with adverse obstetric outcomes. However, less is known regarding subclinical hypothyroidism or thyroid autoimmunity and their relationship to pregnancy complications. Objective The purpose of this study was to examine the association between prepregnancy anti–thyroid antibodies and subclinical hypothyroidism and preterm delivery, gestational diabetes mellitus, and preeclampsia. Study Design We conducted a secondary analysis of a prospective cohort of 18- to 40-year-old women with 1–2 previous pregnancy losses (n=1193) who participated in a multicenter randomized, placebo-controlled trial of low-dose aspirin. Prepregnancy levels of thyroid-stimulating hormone, free thyroxine, thyroglobulin antibody, and thyroid peroxidase antibody were measured. Relative risks and 95% confidence intervals were estimated with the use of generalized linear models with adjustment for age and body mass index. Results Among women with an ongoing pregnancy of >20 weeks estimated gestational age, there was no association between prepregnancy thyroid-stimulating hormone level (>2.5 vs ≤2.5 mIU/L) and preterm delivery (adjusted relative risk, 0.77; 95% confidence interval, 0.40–1.47), gestational diabetes mellitus (adjusted relative risk, 1.28; 95% confidence interval, 0.54–3.04), or preeclampsia (adjusted relative risk, 1.20; 95% confidence interval, 0.71–2.04). Similarly, among women with thyroid antibodies, there was no increase in the likelihood of preterm delivery (relative risk, 1.26; 95% confidence interval, 0.65–2.45), gestational diabetes mellitus (relative risk, 1.33; 95% confidence interval, 0.51–3.49), or preeclampsia (relative risk, 1.02; 95% confidence interval, 0.54–1.92), compared with women without these antibodies. Conclusion Among women with 1–2 previous pregnancy losses, subclinical hypothyroidism and thyroid autoimmunity were not associated with an increased risk of preterm delivery, gestational diabetes mellitus, or preeclampsia. These data support current recommendations that low-risk asymptomatic women should not be screened routinely for thyroid dysfunction or autoimmunity.
- Subjects :
- Adult
endocrine system
medicine.medical_specialty
endocrine system diseases
Thyrotropin
030209 endocrinology & metabolism
Article
Preeclampsia
Cohort Studies
Young Adult
03 medical and health sciences
0302 clinical medicine
Hypothyroidism
Pre-Eclampsia
Pregnancy
Thyroid peroxidase
medicine
Humans
Prospective Studies
Autoantibodies
Subclinical infection
030219 obstetrics & reproductive medicine
biology
business.industry
Obstetrics
Obstetrics and Gynecology
medicine.disease
Anti-thyroid autoantibodies
Confidence interval
Pregnancy Complications
Gestational diabetes
Diabetes, Gestational
Thyroxine
Relative risk
Asymptomatic Diseases
Linear Models
biology.protein
Premature Birth
Female
business
Subjects
Details
- ISSN :
- 00029378
- Volume :
- 217
- Database :
- OpenAIRE
- Journal :
- American Journal of Obstetrics and Gynecology
- Accession number :
- edsair.doi.dedup.....b52dd352d652de7121e20c8e30d9d6d2