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gestational thyroid dysfunction

Jianhua Liu, Xiaojun Yu, Meng Xia, Hong Cai, Guixue Cheng, Lina Wu, Qiang Li, Ying Zhang, Mengyuan Sheng, Yong Liu, Xiaosong Qin
BACKGROUND: A laboratory- and region-specific trimester-related reference interval for thyroid hormone assessment of pregnant women were recommended. Whether the division by trimester is suitable requires verification. Here, we tried to establish appropriate reference intervals of thyroid-related hormones and antibodies for normal pregnant women in Northeast China. METHODS: A total of 947 pregnant women who underwent routine prenatal care were grouped via two methods...
December 1, 2016: Clinical Biochemistry
D C Kaluarachchi, T T Colaizy, L M Pesce, M Tansey, J M Klein
OBJECTIVE: Congenital hypothyroidism (CH) with delayed thyroid-stimulating hormone (TSH) elevation is a common form of thyroid dysfunction among premature infants. Routine newborn screening (NBS) may miss infants with CH with delayed TSH elevation. The objective of the study is to determine the prevalence of CH with delayed TSH elevation in premature infants and to identify associated risk factors. STUDY DESIGN: Retrospective analysis of serum thyroid function screening (TFS) at day of life 30 in premature infants <30 weeks gestation, admitted to University of Iowa Neonatal Intensive Care Unit between 1 July 2012 to 30 June 2015...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Virginia Ballesteros, Olga Costa, Carmen Iñiguez, Tony Fletcher, Ferran Ballester, Maria-Jose Lopez-Espinosa
INTRODUCTION: Thyroid hormones (THs) are especially important for brain maturation and development during the fetal period and childhood. Several epidemiological studies have assessed the possible association between exposure to perfluoroalkyl substances (PFAS) and thyroid outcomes during the early stages of life. We aimed to review this evidence. METHODS: We conducted a systematic review in compliance with the PRISMA Statement (search conducted in PubMed and Embase, as well as in the citations of the selected articles)...
November 21, 2016: Environment International
I Khan, O E Okosieme, J H Lazarus
Thyroid dysfunction is common in pregnancy and has adverse fetal and maternal health consequences. A number of challenges in the management of gestational thyroid dysfunction remain unresolved including uncertainties in optimal thresholds for correction of hypothyroidism and strategies for pharmacological management of hyperthyroidism. Areas covered: We addressed key challenges and areas of uncertainty in the management of thyroid dysfunction in pregnancy. Expert commentary: Gestational thyroid hormone reference intervals vary according to population ethnicity, iodine nutrition, and assay method and each population should derive trimester specific reference intervals for use in pregnancy...
October 26, 2016: Expert Review of Clinical Pharmacology
Zoe Daniel, Angelina Swali, Richard Emes, Simon C Langley-Evans
BACKGROUND: Fetal exposure to a maternal low protein diet during rat pregnancy is associated with hypertension, renal dysfunction and metabolic disturbance in adult life. These effects are present when dietary manipulations target only the first half of pregnancy. It was hypothesised that early gestation protein restriction would impact upon placental gene expression and that this may give clues to the mechanism which links maternal diet to later consequences. METHODS: Pregnant rats were fed control or a low protein diet from conception to day 13 gestation...
2016: Genes & Nutrition
Tim I M Korevaar, Eric A P Steegers, Victor J Pop, Maarten A Broeren, Layal Chaker, Yolanda B de Rijke, Vincent W V Jaddoe, Marco Medici, Theo J Visser, Henning Tiemeier, Robin P Peeters
CONTEXT: Thyroperoxidase antibody (TPOAb) positivity is the main risk factor for thyroid dysfunction during pregnancy and is consistently associated with premature delivery. However, the underlying mechanism is currently unknown. We hypothesized that TPOAb positivity may interfere with gestational thyroid stimulation induced by the pregnancy hormone human chorionic gonadotropin (hCG). DESIGN, SETTING AND PARTICIPANTS: TSH, FT4, TPOAbs and/or hCG concentrations were measured in early and late pregnancy of 7587 pregnant women from two Dutch population-based prospective cohorts (N=5924 Generation R; N=1663 HAPPY)...
October 18, 2016: Journal of Clinical Endocrinology and Metabolism
Nissim Arbib, Eran Hadar, Orly Sneh-Arbib, Rony Chen, Arnon Wiznitzer, Rinat Gabbay-Benziv
PURPOSE: Maternal thyroid gland dysfunction may adversely affect pregnancy outcome. We aimed to examine the association between subclinical thyroid dysfunction, both hypothyroidism and hyperthyroidism, to adverse pregnancy outcome. MATERIALS AND METHODS: Retrospective cohort study of all women with an available first trimester thyroid function testing and known pregnancy outcome, categorized to subclinical hypothyroidism, or hyperthyroidism and evaluated for complication during gestation and delivery...
October 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
Helen Robinson, Philip Robinson, Michael D'Emden, Kassam Mahomed
BACKGROUND: First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. METHODS: Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient's general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications...
September 2016: Obstetric Medicine
Shuai Yang, Feng-Tao Shi, Peter C K Leung, He-Feng Huang, Jianxia Fan
CONTEXT: Although thyroid dysfunction in early pregnancy may have adverse effects on pregnancy outcome and offspring, few prospective studies have evaluated these effects. OBJECTIVE: Our aim was to evaluate the correlations between different thyroid hormone levels in early pregnancy and the incidence of gestational diabetes mellitus (GDM). SETTING AND PARTICIPANTS: The study comprised 27,513 mothers who provided early pregnancy serum samples for analyses of thyroid function...
September 1, 2016: Journal of Clinical Endocrinology and Metabolism
Fiona L R Williams, Jennifer Watson, Chris Day, Aung Soe, Sateesh K Somisetty, Lesley Jackson, Elena Velten, Anita Boelen
BACKGROUND: Infants <32 weeks' gestation should not be exposed to topical iodine and its avoidance is recommended during pregnancy and breast feeding. Exposure to contrast media and topical iodine is frequently used in many preterm neonates. AIM: To determine whether thyrotropin levels in preterm infants are affected by exposure to intrapartum/neonatal topical iodine and/or the use of iodinated contrast media. DESIGN: Infants <32 weeks' gestation were recruited...
August 26, 2016: Journal of Perinatal Medicine
Tim I M Korevaar, Daan Nieboer, Peter H L T Bisschop, Mariette Goddijn, Marco Medici, Layal Chaker, Yolanda B de Rijke, Vincent W V Jaddoe, Theo J Visser, Ewout W Steyerberg, Henning Tiemeier, Tanja G Vrijkotte, Robin P Peeters
BACKGROUND: Low maternal thyroid function during early pregnancy is associated with various adverse outcomes including impaired neurocognitive development of the offspring, premature delivery and abnormal birthweight. AIM: To aid doctors in the risk assessment of thyroid dysfunction during pregnancy, we set out to investigate clinical risk factors and derive a prediction model based on easily obtainable clinical variables. METHODS: In total, 9767 women during early pregnancy (≤18 week) were selected from two population-based prospective cohorts: the Generation R Study (N = 5985) and the ABCD study (N = 3782)...
December 2016: Clinical Endocrinology
R G Ahmed
Because bisphenol A (BPA) has been detected in animals, the aim of this study was to investigate the possible effects of maternal BPA exposure on the fetal endocrine system (thyroid-adipokine axis). BPA (20 or 40 μg/kg body weight) was orally administered to pregnant rats from gestation day (GD) 1-20. In both treated groups, the dams and their fetuses had lower serum thyroxine (T4) and triiodothyronine (T3) levels, and higher thyrotropin (TSH) level than control dams and fetuses at GD 20. Some histopathological changes in fetal thyroid glands were observed in both maternal BPA groups at embryonic day (ED) 20, including fibroblast proliferation, hyperplasia, luminal obliteration, oedema, and degeneration...
September 2016: Food and Chemical Toxicology
Lorena Mosso, Alejandra Martínez, María Paulina Rojas, Gonzalo Latorre, Paula Margozzini, Trinidad Lyng, Jorge Carvajal, Claudia Campusano, Eugenio Arteaga, Laura Boucai
OBJECTIVE: Thyroid dysfunction and obesity during pregnancy have been associated with negative neonatal and obstetric outcomes. Thyroid hormone reference ranges have not been established for the pregnant Hispanic population. This study defines thyroid hormone reference ranges during early pregnancy in Chilean women and evaluates associations of body mass index (BMI) with thyroid function. DESIGN, PATIENTS, MEASUREMENTS: This is a prospective observational study of 720 healthy Chilean women attending their first prenatal consultation at an outpatient clinic...
December 2016: Clinical Endocrinology
R G Ahmed
This study tested whether the maternal transport of dexamethasone (DEXA) may affect the development of the neuroendocrine system. DEXA (0.2mg/kg b.w., subcutaneous injection) was administered to pregnant rats from gestation day (GD) 1-20. In the DEXA-treated group, a decrease in maternal serum thyroxine (T4), triiodothyronine (T3), and increase in thyrotropin (TSH) levels (hypothyroid status) were observed at GDs 15 & 20 with respect to control group. The reverse pattern (hyperthyroid status) was observed in their fetuses at embryonic days (EDs) 15 & 20...
September 6, 2016: Toxicology Letters
H Vitkova, J Jiskra, D Springer, Z Limanova, Z Telicka, J Bartakova, M Trendelenburg, E Potlukova
Anti-C1q antibodies (anti-C1q) have been implicated in the pathogenesis of autoimmune diseases, including autoimmune thyroid disorders (AITD). The aim of this study was to evaluate the association between anti-C1q and thyroid function in pregnancy-associated AITD. In 96 pregnant women screened positive for AITD (thyroid dysfunction and/or antibodies against thyroperoxidase - TPOAb), anti-C1q were measured during the 9-11th gestational week and after delivery (median 16 months after delivery), and compared to the corresponding serum levels of thyroid hormones...
October 2016: Clinical and Experimental Immunology
Zhao Tong, Zhang Xiaowen, Chen Baomin, Liu Aihua, Zhou Yingying, Teng Weiping, Shan Zhongyan
The objective of this study was to evaluate the association between maternal subclinical thyroid dysfunction and autoimmunity with the risk for intrauterine growth restriction (IUGR).Design is a systematic review and meta-analysis.A literature search was conducted using PubMed, Embase, and Cochrane database. A combination of 2 key words was used to search for the eligible studies: one indexed thyroid dysfunction or antithyroid antibodies; and the other one indexed the adverse neonatal outcomes of pregnancy, such as IUGR, small for gestational age, fetal growth restriction, or low birth weight...
May 2016: Medicine (Baltimore)
Ramandeep Kaur, Kapil Gupta
Miscarriage is the spontaneous loss of a fetus before it is viable, occurring at a rate of 15-20%. Recurrent spontaneous abortion (RSA) or habitual miscarriage is defined as repeated occurrence of 3 or more miscarriages before 20(th) week of gestation accounting for the most common complication of early pregnancy in humans. Various etiological factors responsible for recurrent miscarriage are anatomical, genetical, endocrinological, immunological, and infectious. The endocrinological abnormalities may be polycystic ovarian syndrome, hyperprolactinemia, luteal phase defect, thyroid dysfunction, diabetes, or hyperandrogenism contributing to recurrent pregnancy loss...
April 2016: International Journal of Applied and Basic Medical Research
Alexandra Kautzky-Willer, Jürgen Harreiter, Raimund Weitgasser, Monika Lechleitner
Twenty-six years ago the St. Vincent Declaration aimed for an achievement of a comparable pregnancy outcome in diabetic and non-diabetic women. However, current surveys clearly show that women with pre-gestational diabetes still feature a much higher risk of perinatal morbidity and even increased mortality. This fact is mostly ascribed to a persistently low rate of pregnancy planning and pre-pregnancy care with optimization of metabolic control prior to conception. In addition, obesity increases worldwide, contributing to a growing number of women with type 2 diabetes at a childbearing age, and a further deterioration in outcome in diabetic women...
April 2016: Wiener Klinische Wochenschrift
Maricel V Maffini, Leonardo Trasande, Thomas G Neltner
Perchlorate is an endocrine-disrupting chemical that interferes with the normal functioning of the thyroid gland. Maternal thyroid dysfunction during gestation may alter fetal brain development. Perchlorate contamination is widespread: it is present in the body of all Americans tested and the majority of foods tested. The main sources of food contamination appear to be hypochlorite bleach, a disinfectant and sanitizer, that when poorly managed quickly degrades to perchlorate and perchlorate-laden plastic food packaging for dry food or localized contamination from manufacturing or processing of the chemical...
June 2016: Current Environmental Health Reports
Rosa Vissenberg, Tanja G M Vrijkotte, Joris A M van der Post, Eric Fliers, Mariette Goddijn, Peter H Bisschop
OBJECTIVE: Thyroid dysfunction has been described as a possible risk factor for having an abnormal fetal position at birth. In this study we aim to determine the association between thyroid function in early pregnancy and breech presentation at term. STUDY DESIGN: We used data from the Amsterdam Born Children and their Development (ABCD) cohort. 3347 pregnant women were included between January 2003 and March 2004 in Amsterdam, the Netherlands. Thyroid function tests were performed between 5 and 37 weeks gestational age (median 12...
April 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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