Mild TSH elevations safe in early pregnancy, study shows

  • Li P & al.
  • BMC Endocr Disord
  • 12 Sep 2018

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Mildly elevated levels (2.5-4.0 mIU/L) of thyroid-stimulating hormone (TSH) are not associated with adverse pregnancy outcomes during the first trimester in women with thyroid peroxidase antibody (TPOAb)-negative status.

Why this matters

  • This study helps clarify the healthy range for TSH levels during pregnancy.

Key results

  • Median TSH levels were 1.07 mIU/L, and 7.6% of subjects had mildly elevated TSH levels.
  • Patients with mildly elevated TSH and those with normal TSH (.05 for intrauterine growth restriction, gestational diabetes mellitus, gestational hypertension/preeclampsia, premature rupture of membranes, placental abruption, placenta previa, premature delivery, postpartum hemorrhage, assisted vaginal delivery/cesarean section, low birth weight, small for gestational age, large for gestational age, or low Apgar score).
  • TSH levels were not significantly associated with incidence of spontaneous abortion (P=.45).

Study design

  • 1858 women with TPOAb-negative status in the first trimester of pregnancy were analyzed for associations between TSH levels and adverse outcomes.
  • Funding: Science and Technology Planning Project of Guangdong province; Medical Scientific Research Foundation of Guangdong Province.

Limitations

  • No thyroid ultrasonography or analysis of thyroglobulin antibody was performed.

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