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Thyroid test and pregnancy

James E Haddow, Boyd E Metzger, Geralyn Lambert-Messerlian, Elizabeth Eklund, Donald Coustan, Patrick Catalano, Glenn E Palomaki
Purpose: Explore maternal BMI relationship with peripheral deiodinase activity further. Examine associations between deiodinase activity, glucose and C-peptide. Consider findings in historical context of related existing literature. Methods: Identify fasting plasma samples and selected demographic, biophysical, and biochemical data from a subset of 600 randomly selected non-Hispanic Caucasian women recruited in the Hyperglycemia Adverse Pregnancy Outcomes (HAPO) study, all with glucose tolerance testing [545 samples sufficient to measure thyrotropin (TSH), free thyroxine (fT4), and triiodothyronine (T3)]...
February 11, 2019: Journal of Clinical Endocrinology and Metabolism
Kristina M Cordasco, Anita H Yuan, Marjorie J Danz, Melissa M Farmer, LaShawnta Jackson, Ellen F Yee, Donna L Washington
BACKGROUND: Abnormal uterine bleeding (AUB) is common among primary care patients. We assessed the extent to which Veterans Health Administration (VA) primary care patients with AUB are receiving guideline-adherent primary care. METHODS: We identified women with AUB presenting to primary care providers across four VA health care systems from June 2013 to September 2015. We performed a structured abstraction of electronic medical record data for 15 indicators of guideline-adherent AUB care...
February 2, 2019: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Mario Rotondi, Valentina Capelli, Luca Chiovato, Rossella E Nappi
In the past two decades, the issue of thyroid dysfunctions during pregnancy and the postpartum period received increasing attention by both endocrinologists and obstetrics/gynecologists (OB/GYNs), the latter often became the first to diagnose an impaired thyroid function in pregnant women. In this setting, a series of different clinical guidelines have been published and reviewed, the latest ones being represented by the 2017 ATA guidelines, which extensively address a wide variety of topics, including iodine supplementation, thyroid autoimmunity, hyper- and hypo-thyroidism, thyroid nodules and cancer, post-partum management, as well as the need for pre-conception screening...
February 5, 2019: Gynecological Endocrinology
Kun Huang, Yeqing Xu, Shuangqin Yan, Tao Li, Yuanhong Xu, Peng Zhu, Fangbiao Tao
This article aims to understand the isolated effect of maternal thyroid-stimulating hormone (TSH), free thyroxine (FT4 ) and antithyroid peroxidase antibodies (TPOAb) in early pregnancy on gestational diabetes mellitus (GDM). Based on a birth cohort, pregnant women presented to maternity hospitals for the first antenatal care from Nov 2008 to Oct 2010 were invited to participate in the study. A self-administered questionnaire was asked to complete to collect data on socio-economic variables, previous adverse pregnancy outcomes, method of conception, previous endocrinic and metabolic diseases, and pregnancy-related anxiety in 1st trimester of the index pregnancy...
January 24, 2019: Endocrine Journal
Selma Amrane, Rachel McConnell
OBJECTIVE: To review the available data on endocrine disorders and recurrent pregnancy loss. FINDINGS: Our group found that most endocrine disorders do not seem to be correlated with a diagnosis of recurrent pregnancy loss (RPL). The exception to this is testing for thyroid stimulating hormone and thyroid antibodies, which is recommended due to a strong correlation with recurrent pregnancy loss and positive anti-thyroid peroxidase antibodies. CONCLUSION: The available literature supports testing thyroid function and antibodies in women with RPL...
December 20, 2018: Seminars in Perinatology
Stine Linding Andersen
Thyroid function in pregnant women is of clinical importance considering the crucial role of thyroid hormones during fetal brain development, but the current level of evidence is insufficient to recommend for or against the routine testing of thyroid function in pregnant women. As part of this debate, it is important to evaluate the frequency of undiagnosed and untreated thyroid function abnormalities in pregnant women and to address challenges related to the biochemical assessment of maternal thyroid function in early pregnancy...
January 8, 2019: Scandinavian Journal of Clinical and Laboratory Investigation
Lois Elizabeth Donovan, Amy Metcalfe, Alex C Chin, Jennifer M Yamamoto, Heidi Virtanen, Jo-Ann Johnson, Richard Krause
BACKGROUND: Population, assay and trimester specific reference intervals for thyroid function tests are necessary to accurately assess thyroid status and manage thyroid disease throughout pregnancy. This study's objective was to verify if the manufacturer's recommended trimester specific reference intervals for thyroid tests and American Thyroid Association's recommended Total T4 (TT4) pregnancy reference intervals were verifiable and appropriate for use in our population. METHODS: Blood samples were obtained from the following sources: stored frozen surplus blood from women undergoing routine aneuploidy screening (first and second trimester samples, n = 274), and women participating in an observational cohort study, (second and third trimester samples, n = 135) and blood collected from women presenting for assessment to the labour and delivery ward (third trimester samples n =35)...
December 29, 2018: Thyroid: Official Journal of the American Thyroid Association
Roberto Laureano-Melo, Janaina Sena de Souza, Rodrigo Rodrigues da Conceição, Josie Marcelle Lira Albuquerque, Nayana Coutinho Rodrigues, Bruno Guimarães Marinho, Emerson Lopes Olivares, Gisele Giannocco, Wellington da Silva Côrtes
The proper functioning of the maternal thyroid plays a crucial role in fetal development. Thus, the aim of our study was to verify how maternal hyperthyroidism is able to change behavioral parameters in mice offspring during adulthood. For this purpose, pregnant Swiss mice (n = 24 and ~35 g) were randomly assigned into two groups: a control and a thyroxine (T4)-treatment group. The control was treated with 0.9% saline, while the treatment group received T4 (200 μg/kg, s.c.) once daily during the entire pregnancy period...
December 18, 2018: Hormones and Behavior
Vishal S Bhella, Divya Garg
The thyroid hormone triiodothyronine (T3) can be used as an augmentation therapy for depression. This case involves a patient who had been initiated on liothyronine (L-T3) for this purpose and subsequently became pregnant. The exogenous T3 affected maternal thyroid hormone production, including suppression of her thyroxine (T4) levels. In pregnancy, maternal T4 is important for fetal neurodevelopment. Accordingly, use of exogenous T3 for adjunct treatment of depression in pregnant patients or those planning pregnancy requires careful laboratory monitoring of thyroid function tests...
December 7, 2018: BMJ Case Reports
Peter Shane Hamblin, Penelope M Sheehan, Carolyn Allan, Christine A Houlihan, Zhong X Lu, Simon P Forehan, Duncan J Topliss, Christopher Gilfillan, Bala Krishnamurthy, Debra Renouf, Shoshana Sztal-Mazer, Suresh Varadarajan
BACKGROUND: Interest in potential adverse outcomes associated with maternal subclinical hypothyroidism (normal Free T4, elevated TSH) has increased significantly over recent years. In turn, the frequency of maternal thyroid function testing has risen, despite universal thyroid function screening not being recommended, leading to a marked increase in referrals to obstetric endocrinology clinics. In 2017 the American Thyroid Association (ATA) revised their diagnostic and management guidelines...
December 18, 2018: Internal Medicine Journal
Di Wu, Rui Guo, Huiling Guo, Yushu Li, Haixia Guan, Zhongyan Shan
BACKGROUND: Resistance to thyroid hormone beta (RTHβ) results in symptoms of both increased and decreased thyroid hormone action. The effect of thyroid hormone changes in different types of autoimmune thyroid disease (AITD) in RTHβ is dynamic. CASE PRESENTATION: A 25-year-old Asian female had a RTHβ Y321C mutation with Hashimoto's thyroiditis and type 2 diabetes mellitus. She was followed-up through gestation and two years postpartum, revealing development of postpartum thyroiditis (PPT) with characteristic wide fluctuations in serum thyrotropin levels, and of spontaneous recovery from an episode of transient hypothyroidism...
December 3, 2018: BMC Pregnancy and Childbirth
Peter N Taylor, Stamatios Zouras, Thinzar Min, Kalyani Nagarahaj, John H Lazarus, Onyebuchi Okosieme
Universal thyroid screening in pregnancy is a key debate in thyroidology and obstetrics. It is well-established that thyroid hormones are essential for maintaining pregnancy and optimal fetal development. Thyroid dysfunction is common in women of child-bearing age and also results in substantial adverse obstetric and child neurodevelopmental outcomes. Furthermore, thyroid dysfunction is readily diagnosed with reliable blood tests and easily corrected with inexpensive and available treatments. Screening only high-risk patients appears to miss the majority of cases and economic models show that compared to high-risk screening, universal screening is cost effective even if only overt hypothyroidism was assumed to have adverse obstetric effects...
2018: Frontiers in Endocrinology
R Shah, S V Brodsky, L Hebert, B H Rovin, T Nadasdy, A A Satoskar
Antiphospholipid antibody syndrome (APS) is an acquired prothrombotic autoimmune disease caused by the presence of antibodies against anionic phospholipids or plasma proteins bound to phospholipids on cell membranes. It can be a primary disease or secondary to other autoimmune diseases, most commonly systemic lupus erythematosus (SLE). Laboratory testing for antiphospholipid antibodies (aPL) may be only transiently positive, so APS could be missed until a catastrophic thrombotic episode or pregnancy morbidity occurs...
December 2018: Lupus
Lijin Ji, Na Yi, Qi Zhang, Shuo Zhang, Xiaoxia Liu, Hongli Shi, Bin Lu
Objective To assess the current management of prolactinoma among endocrinologists in China. Methods An online survey of a large sample of endocrinologists was conducted in China. The questionnaire included 21 questions related to controversial issues about the management of prolactinomas. Doctors in the endocrinology department of a university-affiliated hospital or a comprehensive secondary hospital in 12 cities from East, West, South, North and Middle China were surveyed. Results A total of 290 valid questionnaires were collected, and the response rate was 40%...
October 1, 2018: Endocrine Connections
Diana Alecsandru, Ana Barrio, Victor Andia, Edgar Cruz, Pilar Aparicio, Jose Serna, Maria Cruz, Antonio Pellicer, Juan Antonio Garcia-Velasco
Pancreatic Autoimmunity is defined as the presence of autoantibodies and more frequent need for insulin treatment. Affected women presenting recurrent implantation failure (RIF) or recurrent miscarriage (RM) are often misdiagnosed. The objective of thestudy was to describe clinical and metabolic profiles suggestive of Pancreatic Autoimmunity and therapeutic strategy in patients with RIF/RM. We analyzed retrospectively 735 patients, and have identified a subset (N = 20) with similar metabolic characteristics...
2018: PloS One
Mehwish Gilani, Naveed Asif, Ammad Akram, Mehreen Gilani, Aamir Ijaz, Saima Shakil Malik
OBJECTIVE: To determine the reference values for thyroid stimulating hormone, free tetra-iodothyronine and total tri-iodothyronine for healthy pregnant women. METHODS: This cross sectional study was conducted at the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from January 2016 to June 2017. Pregnant women with normal, single intrauterine, uncomplicated pregnancy were recruited from the local population. Blood sample was taken to analyse thyroid stimulating hormone, free tetra-iodothyronine and total tri-iodothyronine using chemiluminescence immunoassay...
October 2018: JPMA. the Journal of the Pakistan Medical Association
Young Ah Lee, Sun Wook Cho, Ho Kyung Sung, Kyungsik Kim, Young Shin Song, Sin Je Moon, Jung Won Oh, Dal Lae Ju, Sooyeon Choi, Sang Hoon Song, Gi Jeong Cheon, Young Joo Park, Choong Ho Shin, Sue K Park, Jong Kwan Jun, June Key Chung
BACKGROUND: Iodine is an intrinsic element of thyroid hormone, which is essential for childhood growth and development. The Ideal Breast Milk (IBM) cohort study aims to evaluate the effects of maternal iodine status during pregnancy and lactation on maternal thyroid function, offspring growth and development, and offspring thyroid function. METHODS: The IBM cohort study recruited pregnant women from Seoul National University Hospital between June 2016 and August 2017, followed by enrollment of their offspring after delivery...
September 2018: Endocrinology and Metabolism
K M van Veggel, J M Rondeel, S Anten
BACKGROUND: Thyroid function tests may show the combination of a normal concentration of serum thyroidstimulating hormone (TSH) and an increased or decreased level of free thyroxine (free T4). How often this occurs is unclear and not everyone is familiar with how it should be adressed. METHODS: We conducted a retrospective cohort study of all adult patients who presented at a non-academic general hospital in the Netherlands between 1 January 2010 and 31 December 2014 and yielded an increased or decreased free T4 in combination with a normal TSH...
September 2018: Netherlands Journal of Medicine
Shui Boon Soh, Tar Choon Aw
Thyroid disorders are common, affecting more than 10% of people in the US, and laboratory tests are integral in the management of these conditions. The repertoire of thyroid tests includes blood tests for thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine, thyroglobulin (Tg), thyroglobulin antibodies (Tg-Ab), thyroid peroxidase antibodies (TPO-Ab), TSH receptor antibodies (TRAb), and calcitonin. TSH and free thyroid hormone tests are frequently used to assess the functional status of the thyroid...
January 2019: Annals of Laboratory Medicine
Xiaotong Gao, Yongze Li, Jiashu Li, Aihua Liu, Wei Sun, Weiping Teng, Zhongyan Shan
Background: Serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) change dynamically during pregnancy. Differences in geographic regions, populations, and manufacturer's methodologies can affect the reference intervals for thyroid function tests. The 2017 guidelines of the American Thyroid Association (ATA) recommended 4.0 mU/L as the cut-off point for the upper limit of serum TSH in early pregnancy. A systematic review is called for to establish practical, gestational-specific TSH and FT4 reference intervals for pregnant Chinese women and to explore whether the criteria are suitable for China...
2018: Frontiers in Endocrinology
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