The prevalence of maternal hypothyroidism in first trimester screening from 11 to 14 weeks of gestation
Jazyk angličtina Země Česko Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články, pozorovací studie
PubMed
30401989
DOI
10.5507/bp.2018.063
Knihovny.cz E-zdroje
- Klíčová slova
- gestation, hypothyroidism, immunoassay, pregnancy, thyroid disease,
- MeSH
- dospělí MeSH
- hypotyreóza krev diagnóza MeSH
- imunoanalýza metody MeSH
- jodidperoxidasa imunologie MeSH
- komplikace těhotenství krev diagnóza MeSH
- lidé MeSH
- protilátky metabolismus MeSH
- první trimestr těhotenství MeSH
- retrospektivní studie MeSH
- těhotenství s dvojčaty fyziologie MeSH
- těhotenství MeSH
- thyreotropin metabolismus MeSH
- thyroxin metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- srovnávací studie MeSH
- Názvy látek
- jodidperoxidasa MeSH
- protilátky MeSH
- thyreotropin MeSH
- thyroxin MeSH
AIM: The aim of this study was to determine the prevalence of maternal hypothyroidism in the first trimester from 11 to 14 weeks of gestation according to the American Thyroid Association (ATA) guidelines from 2017 and to compare the rates for singleton and twin pregnancies. METHODS: A total of 4965 consecutive Caucasian singleton pregnancies and 109 Caucasian twin pregnancies were included in the investigation. Patients with a history of thyroid gland disorder were excluded. Subclinical maternal hypothyroidism was defined as a thyroid stimulating hormone (TSH) concentration above the 97.5th percentile and free thyroxine (fT4) within the range of a reference population of women at 11-14 weeks of gestation. Overt maternal hypothyroidism was defined as a TSH concentration above the 97.5th percentile and an fT4 below the 2.5th percentile of the reference population.TSH, fT4, and anti thyroid peroxidase antibody (TPOAb) were measured by immunochemiluminescent assays on an 16200 Abbott Architect analyzer. RESULTS: The prevalence of hypothyroidism for twin pregnancies was no higher than that for singleton pregnancies; 6.42% (7/109) vs. 5.32% (264/4965), respectively; P=0.61. All twin pregnancies were subclinical. Singleton hypothyroid pregnancies included 4.91% (244 cases) of subclinical and 0.41% (20 cases) of overt hypothyroidism. The prevalence of TPOAb positive hypothyroid women for twin pregnancies and singleton pregnancies was 71% (5/7) vs. 52% (137/264 cases), respectively but the differences were not statistically significant; P=0.31. CONCLUSION: Each first trimester screening center should establish its TSH and fT4 reference ranges. Our center had higher upper reference limits of TSH than that of the universally fixed limit of 2.5 mU/L, which led to a lower measured prevalence of maternal hypothyroidism. A large number of hypothyroid women were TPOAb positive.
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