We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Technopath Clinical Diagnostics

Download Mobile App




Events

ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Pregnancy TSH Variations Prompt Erroneous Thyroid Disease Diagnosis

By LabMedica International staff writers
Posted on 22 Jun 2020
Print article
Image: Thyroid-stimulating hormone variations in pregnancy may prompt erroneous subclinical thyroid disease diagnosis (Photo courtesy of HealthEngine).
Image: Thyroid-stimulating hormone variations in pregnancy may prompt erroneous subclinical thyroid disease diagnosis (Photo courtesy of HealthEngine).
Thyroid-stimulating hormone is a pituitary hormone that stimulates the thyroid gland to produce thyroxine, and then triiodothyronine which stimulates the metabolism of almost every tissue in the body.

Physiologic variations in thyroid-stimulating hormone (TSH) concentrations may lead to a misclassification of subclinical thyroid disease for some healthy pregnant women, possibly subjecting women to unnecessary treatment.

Endocrinologists at the Medical University of Lodz (Rzgowska, Poland) and their colleagues assessed baseline concentrations of free T4, free T3, as well as TSH at 30 minute intervals (between 7.00 and 9.00 hours) in 110 healthy pregnant women, age 30.2 ± 6.0 years, 9.9 ± 2.4 weeks of gestation and in 19 female controls age 28.9 ± 10.7. The scientists analyzed data from the healthy pregnant women (mean age, 30 years; mean BMI, 24.9 kg/m²; mean gestational age, 9.9 weeks), hospitalized at Polish Mother’s Memorial Hospital Research Institute between 2017 and 2019, as well as the non-pregnant healthy women (mean age, 29 years; mean BMI, 28.3 kg/m²).

Based on data from 550 measurements, the team found that mean TSH concentrations were 1.62 mIU/L and 1.67 mIU/L among pregnant women and controls, respectively. Women who were Thyroid peroxidase (TPO) antibody-positive had a higher TSH concentration versus women who were TPO antibody-negative (mean TSH, 3.17 mIU/L versus 1.62 mIU/L). Taking into account the highest TSH out of five consecutive measurements, the scientists found that 20.9% of pregnant women had a TSH measurement greater than 2.5 mIU/L and 9.1% of pregnant women had a TSH measurement greater than 4 mIU/L.

When considering the lowest TSH value, the investigators observed TSH measurements greater than 2.5 mIU/L in 12.7% of pregnant women and TSH measurements greater than 4 mIU/L in 3.6% of pregnant women. The team found that the discrepancy was even greater for women who were TPO antibody-negative, varying between 21.2% versus 8.1% for a TSH greater than 2.5 mIU/L when considering the highest versus. the lowest TSH values, and varying between 6.06% versus 1.01% for a TSH greater than 4 mIU/L when considering the highest versus the lowest TSH values. They also found that TSH concentrations varied by 39.5% for pregnant women and by 42.47% among controls, with no between-group difference.

Andrzej Lewinski, MD, PhD, a Professor of Endocrinology and the senior author of the study, said, “Any decisions to instigate treatment, particularly during such a sensitive period like pregnancy, should be based on clear data that define what TSH and thyroid hormone concentrations are abnormal, as well as evidence of definite benefit of treatment. Furthermore, assessment of thyroid function should be performed during the first trimester of pregnancy, as fetal development is then almost entirely dependent on maternal thyroid hormone concentrations. In such circumstances, it is mandatory to ascertain that one is dealing with a genuine abnormality and not with physiological variations in hormone concentrations.” The study was published on May 19, 2020 in the journal Clinical Endocrinology.

Related Links:
Medical University of Lodz


Print article

Channels

Molecular Diagnostics

view channel
Image: Photomicrograph of histopathology of Barrett`s esophagus showing the characteristic goblet cells (Alcian blue stain) (Photo courtesy of Nephron).

Genomic Copy Number Predicts Esophageal Cancer Years Before Transformation

Barrett’s esophagus is a condition in which the lining of the esophagus changes, becoming more like the lining of the small intestine rather than the esophagus. This occurs in the area where the esophagus... Read more

Immunology

view channel
Image: An enzyme-linked immunosorbent assay for mannose-binding lectin found that this molecule is associated with coagulopathy in severe COVID-19 patients (Photo courtesy of Getty Images).

Mannose-Binding Lectin Associated with Coagulopathy in Severe COVID-19

The ongoing COVID-19 pandemic has caused significant morbidity and mortality worldwide, as well as profound effects on society. COVID-19 patients have an increased risk of thromboembolic (TE) complications,... Read more

Industry News

view channel
Illustration

2020 AACC Annual Scientific Meeting & Clinical Lab Expo to Be an All Virtual Event Due to Coronavirus Pandemic

The American Association for Clinical Chemistry (AACC Washington, DC, USA) has decided to hold the 2020 AACC Annual Scientific Meeting & Clinical Lab Expo as a virtual event, rather than as a live... Read more
Copyright © 2000-2020 Globetech Media. All rights reserved.