Temporal trends in thyroid-stimulating hormone and live birth rate in subclinical hypothyroid patients in a recurrent pregnancy loss population.

Autor: Jansen S; University of British Columbia, Vancouver, BC V6T 1Z4, Canada., Leduc-Robert G; University of British Columbia, Vancouver, BC V6T 1Z4, Canada., AbdelHafez FF; University of British Columbia, Vancouver, BC V6T 1Z4, Canada; Assiut School of Medicine, Assiut University, Assiut, Egypt., Albert A; Division of Reproductive Endocrinology and Infertility, BC Women's Hospital and Health Research Institute, Vancouver, BC V6H 2N9, Canada., Mayer U; Division of Reproductive Endocrinology and Infertility, BC Women's Hospital and Health Research Institute, Vancouver, BC V6H 2N9, Canada., Bedaiwy MA; University of British Columbia, Vancouver, BC V6T 1Z4, Canada; Division of Reproductive Endocrinology and Infertility, BC Women's Hospital and Health Research Institute, Vancouver, BC V6H 2N9, Canada. Electronic address: mohamed.bedaiwy@cw.bc.ca.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2022 Oct; Vol. 277, pp. 21-26. Date of Electronic Publication: 2022 Aug 02.
DOI: 10.1016/j.ejogrb.2022.07.034
Abstrakt: Objectives: The purpose of this study was to explore if thyroperoxidase antibody positivity impacts thyroid stimulating hormone levels during pregnancies following the index visit and how live birth rate is impacted when treated subclinical hypothyroidism is treated with levothyroxine or not.
Study Design: A retrospective chart review of 1443 recurrent pregnancy loss patients from BC Women's Hospital recurrent pregnancy loss clinic was conducted. Thyroid stimulating hormone in pregnancies after the index visit across thyroperoxidase antibody status was analyzed using mixed-effects linear regression. Live birth rate in patients with subclinical hypothyroidism (thyroid stimulating hormone 2.5-10 mIU/L) with levothyroxine treatment was compared to those without relative to euthyroid patients using logistic regression.
Results and Conclusions: There was no significant difference in patient demographics including age, body mass index, or number of previous live births or pregnancy losses between groups. The distribution of recurrent pregnancy loss causes between groups revealed no difference in proportion of patients with anti-phospholipid antibody syndrome, hereditary thrombophilia, hyperprolactinemia, or anatomic causes. There was no significant change in thyroid stimulating hormone across thyroperoxidase antibody or treatment status (p = 0.24) for up to four subsequent pregnancies. An increased live birth rate in subclinical hypothyroidism when treated with levothyroxine relative to untreated (OR = 2.25, p < 0.001) was seen. Thyroid stimulating hormone values do not change over time following the index visit for up to 4 subsequent pregnancies irrespective of the thyroxperoxidase antibody status. An increase in live birth rate was found in patients with borderline subclinical hypothyroidism when treated with levothyroxine.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mohamed A. Bedaiwy is on the advisory board for AbbVie and Baxter and has received research grant funding from Ferring.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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