Study identifies prognostic cutoff value for first trimester TSH

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Takeaway

  • In a retrospective study, a cutoff value of 2.5 mIU/L maternal thyrotropin (TSH) is associated with risk for obstetric and fetal complications for pregnant women during the first trimester.

Why this matters

  • The correct upper limit of TSH during pregnancy is controversial.

Key results

  • Median TSH was 1.72 mIU/L (range, 0.01-15.1 mIU/L).
  • 7.2% of women experienced perinatal loss, 5.9% experienced miscarriage, 3.2% experienced preeclampsia, and 1.1% experienced stillbirth.
  • Women who experienced miscarriage had significantly higher median TSH compared with women who did not (1.97 vs 1.71 mIU/L; P=.009).
  • Women who experienced preeclampsia had significantly higher median TSH compared with women who did not (2.19 vs 1.71 mIU/L; P=.027).
  • Women with TSH 2.5-5.1 mIU/L had increased risk for any perinatal loss (OR, 1.589; P=.017), miscarriage (OR, 1.702; P=.012), and premature birth (OR, 1.379; P=.041) in age-adjusted analysis.

Study design

  • 1981 pregnant women from a single hospital were analyzed retrospectively for associations between TSH levels and fetal-maternal complications.
  • Funding: Instituto de Salud Carlos III.

Limitations

  • Retrospective study.