Fetal Free Thyroxine Concentrations in Pregnant Women with Autoimmune Thyroid Disease
| Autor: | Jelena Marinkovic, Nebojsa Radunovic, Svetlana Spremovic-Radjenovic, Aleksandra Gudovic, Gordana Lazovic, Aleksandar Ljubic |
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| Rok vydání: | 2012 |
| Předmět: |
endocrine system
medicine.medical_specialty Wolff–Chaikoff effect endocrine system diseases Endocrinology Diabetes and Metabolism Clinical Biochemistry Thyrotropin 030209 endocrinology & metabolism Thyroid Function Tests Hyperthyroidism Biochemistry Thyroid function tests Ultrasonography Prenatal Autoimmune Diseases 03 medical and health sciences 0302 clinical medicine Endocrinology Hypothyroidism Pregnancy Thyroid peroxidase Internal medicine medicine Humans Euthyroid Prospective Studies 030212 general & internal medicine Prospective cohort study biology medicine.diagnostic_test business.industry Biochemistry (medical) Thyroid Fetal Blood Anti-thyroid autoantibodies 3. Good health Pregnancy Complications Thyroxine medicine.anatomical_structure biology.protein Female Thyroid function business hormones hormone substitutes and hormone antagonists |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 97:4014-4021 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2012-1392 |
| Popis: | Fetuses from mothers with autoimmune thyroid disease (AITD) may be affected by antithyroid antibodies, antithyroid drugs, and iodine.The study correlated fetal free T(4) (fT4) with fetal ultrasound parameters and maternal thyroid function, thyroid antibodies, and medication dose from mothers with AITD.The study was designed as a prospective cohort study and conducted in an academic referral center.Eighty-three of 85 women with AITD completed the study; 38 were treated for hyperthyroidism and 25 for hypothyroidism, and 20 were euthyroid.Outcomes were as follows: 1) fetal-fT4, TSH, ultrasound parameters (morphology, biometrics, heart rate); and 2) maternal-fT4, TSH, antithyroid drug dose, and antithyroid antibodies, thyroid peroxidase and TSH receptor (TRAK). Parameters were determined at the same time, between the 22nd and 33rd wk gestation.A total of 48.3% of fetuses from hyperthyroid mothers, 60% of fetuses from hypothyroid mothers, and 10% of fetuses from euthyroid mothers had elevated fT4 levels (P = 0.006). In hypothyroid mothers, the presence of both thyroid antibodies was related to fetal hyperthyroidism, whereas absence was related to fetal euthyroidism (P = 0.019). Hyperthyroid mothers (TRAK-positive, thyroid peroxidase-negative) with hyperthyroid fetuses had significantly higher mean TRAK than hyperthyroid mothers with euthyroid fetuses (13.7 vs. 3.7 IU/liter; P = 0.02). Fetal fT4 correlated weakly negatively with maternal TSH within the normal range, but not with ultrasound parameters or with antithyroid drug dose.High fetal fT4 levels were unexpectedly frequent in women with AITD, including maternal autoimmune hypo- and hyperthyroidism. Further studies are needed, as well as noninvasive methods to assess fetal thyroid function. |
| Databáze: | OpenAIRE |
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