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Maternal thyroid hormone level during pregnancy plays a crucial role in development of neonate and children.1 Any gestational period thyroid hormone disorder may lead to obstetrical complications along with effects on fetus.2 Fetal growth is also affected by maternal thyroid levels.3 Various physiological changes, alterations of TBGs, β-hCG level, and change of iodide metabolism affect maternal thyroid hormone levels.4 Therefore, to ensure optimal maternal and fetal health, it is recommended to properly assess thyroid function of all pregnant women with a distinct established reference range other than the one mentioned in the kit literature. According to the International Federation of Clinical Chemistry (IFCC), RI is defined as an interval, i.e., bounded by two percentiles of the reference distribution, where a percentile represents a value that splits the reference distribution in a way that a stated percentage of its values has levels less than or equal to the limiting value. Most commonly, the RI of a parameter is defined as the central 95% interval bounded by the 2.5 and 97.5 percentiles of the reference distribution.5-8 For valid comparison to establish gestational thyroid reference range, the study population must be homogeneous to the reference individual in all respects; therefore, trimester-specific RIs of thyroid hormone can only provide the best therapeutic guideline for clinical decision making.9 In India and other developing and underdeveloped world, the most commonly ordered thyroid function tests are serum total T3, total T4, and TSH levels. Most common method followed is ELISA. Though free T3 and free T4 should be performed ideally as no better sensitive method is available, but due to various socioeconomic conditions, it is not yet possible for largely populated countries to conduct them. 1Graded Specialist, 2Classified Specialist, 3Medical Officer 4Senior Advisor 1Department of Pathology, Military Hospital, Ranchi, Jharkhand India

Specific Reference Intervals of Serum Triiodothyronine, Thyroxine, and Thyroid-stimulating Hormone in Normal Pregnant Indian Women as per Trimester