Maternal hypothyroidism and adverse outcomes of pregnancy.

Autor: Knøsgaard L; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Andersen S; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark., Hansen AB; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark., Vestergaard P; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.; Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark., Andersen SL; Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Jazyk: angličtina
Zdroj: Clinical endocrinology [Clin Endocrinol (Oxf)] 2023 May; Vol. 98 (5), pp. 719-729. Date of Electronic Publication: 2022 Nov 28.
DOI: 10.1111/cen.14853
Abstrakt: Objective: Hypothyroidism has been associated with pregnancy complications, but uncertainty prevail regarding the severity and the role of thyroid autoimmunity. This study aimed to evaluate adverse pregnancy outcomes by exposure to maternal hypothyroidism and thyroid autoimmunity.
Design: Retrospective cohort study.
Patients: 14,744 singleton pregnancies from the North Denmark Region Pregnancy Cohort (2011-2015).
Measurements: Maternal thyroid stimulating hormone (TSH), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab) were retrospectively measured in early pregnancy blood samples (ADVIA Centaur XPT, Siemens Healthineers). Adjusted odds ratio (aOR) with 95% confidence interval (CI) was used to estimate associations between maternal hypothyroidism (TSH cut-offs: 6.0 and 10 mIU/L), thyroid autoimmunity (TPO-Ab cut-off: 60 U/ml, Tg-Ab cut-off: 33 U/ml), and adverse pregnancy outcomes.
Results: Pregnancy outcomes were 93.2% live births, 6.5% spontaneous abortions, and 0.3% stillbirths. The frequency of spontaneous abortion was 6.5% when TSH was below 6.0 mIU/L, 6.5% when above 6.0 mIU/L (aOR 1.0 [95% CI: 0.5-2.0]), and 12.5% when above 10 mIU/L (aOR: 2.0 [95% CI: 0.8-5.2]). For outcome of preterm birth, the frequency was 5.4% when TSH was below 6.0 mIU/L, 7.8% when above 6.0 mIU/L (aOR 1.5 [95% CI: 0.7-2.9]), and 11.4% when above 10 mIU/L (aOR: 2.6 [95% CI: 0.9-7.3]). No association was found between thyroid autoantibodies and spontaneous abortion (TPO-Ab: aOR: 1.0 [0.8-1.3], Tg-Ab: 1.0 [0.8-1.2]) or preterm birth (TPO-Ab: aOR: 1.0 [0.8-1.2], Tg-Ab: 0.9 [0.7-1.2]).
Conclusion: A high frequency of adverse pregnancy outcomes was seen among pregnancies exposed to maternal TSH above 10 mIU/L, whereas no association with thyroid autoantibodies was seen.
(© 2022 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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