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Objective: The objective was to assess the prevalence of misd iagnosed thyroid dysfunction during the first trime ster of pregnancy when nonpregnant reference intervals used . Materials and Methods: This study, conducted on 233 pregnant women of age between 18 and 35 years during first t r mester. Serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroperoxidase antibodies (TPO Ab) analyzed an thyroid disorders were grouped, based on the f irst trimesterspecific reference intervals and correlated with no npregnant reference intervals. Results: The overall prevalence of autoimmunity was 12.4%. The prevalence of subclinic al hypothyroid (SCH) was significantly higher than euthyroid when first trimester-specific reference intervals u sed rather than nonpregnant reference intervals. If the nonpregnant reference intervals were applied to our study group , 27.9% pregnant women with TSH above the first tri mester-specific reference intervals would not have been identified and misclassified as euthyroid. 22.7% would have mi ssed the diagnosis as SCH. 5.2% with low FT4 levels, among t his 3% and 2.1% would not have been identified as o vert hypothyroid and isolated hypothyroxinemia. The rela tive risk of autoimmunity was significantly 3.66 ti mes more in SCH than euthyroid, when first trimester-specific refer nce intervals used. Conclusion: Misdiagnosis of SCH, overt hypothyroid and autoimmune thyroid disorders occurr ed during the first trimester of pregnancy if nonpr egnant reference intervals used. Undiagnosed hypothyroidism in pregn ant women may adversely affect their fetuses; there fore the early and appropriate detection of thyroid dysfunction re quire reliable pregnancy-specific reference interva ls of the thyroid hormones.

Detection of misdiagnosed thyroid dysfunction in early pregnancy: using nonpregnant and pregnancy specific reference intervals