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Impact of TSH during the first trimester of pregnancy on obstetric and foetal complications: Usefulness of 2.5 mIU /L cut‐off value
Author(s) -
Hernández Marta,
López Carolina,
Soldevila Berta,
Cecenarro Laura,
MartínezBarahona María,
Palomera Elisabet,
Rius Ferran,
Lecube Albert,
Pelegay Maria José,
García Jordi,
Mauricio Dídac,
Puig Domingo Manel
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13575
Subject(s) - medicine , miscarriage , subclinical infection , obstetrics , pregnancy , incidence (geometry) , gestation , gynecology , genetics , physics , optics , biology
Summary Objective An association of pregnancy outcomes with subclinical hypothyroidism has been reported; however, there still exists a strong controversy regarding whether subclinical hypothyroidism ought to be dealt with or not. The objective of the study was to evaluate the association of foetal‐maternal complications with first trimester maternal Thyrotropin ( TSH ) values. Design A retrospective study in a single tertiary care hospital was performed. Patients A total of 1981 pregnant women were studied during 2012. Measurements Thyrotropin ( TSH ) universal screening was performed between 9 and 12 weeks of gestation. Outcomes included foetal‐maternal complications and newborn health parameters. Results Median TSH was 1.72 (0.99‐2.61) mIU /L. The incidence of perinatal loss, miscarriage and stillbirth was 7.2%, 5.9% and 1.1%, respectively. Median TSH of women with and without miscarriage was 1.97 (1.29‐3.28) vs 1.71 (0.96‐2.58) mIU /L ( P = .009). Incidence of pre‐eclampsia was 3.2%; TSH in these women was 2.10 (1.40‐2.74) vs 1.71 (0.98‐2.59) mIU /L in those without ( P = .027). TSH in women with dystocia in labour was 1.76 (1.00‐2.53) vs 1.68 (0.94‐2.59) mIU /L in those who gave birth with normal progression ( P = .044). Women with TSH 2.5‐5.1 mIU /L had a higher risk of perinatal loss [ OR 1.589 (1.085‐2.329)], miscarriage [ OR 1.702 (1.126‐2.572)] and premature birth [ OR 1.39 (1.013‐1.876)], adjusted by mother's age. There was no association with the other outcomes analysed. Conclusions There is a positive association between maternal TSH in the first trimester of pregnancy and the incidence of perinatal loss and miscarriage. The TSH cut‐off value of 2.5 mIU /L identified women with higher adverse pregnancy outcomes.