Impact of subclinical hypothyroidism in women with recurrent early pregnancy loss
Open accessAbstract
Objective To assess the impact of subclinical hypothyroidism (SCH) in women with recurrent early pregnancy loss (REPL).Design Observational cohort study.Setting REPL program in an academic medical center.Patient(s) 286 women with a history of ≥2 pregnancy losses <10 weeks.Intervention(s) From 2004-2007, no treatment for women with SCH (thyroid-stimulating hormone [TSH] >2.5 mIU/L with a normal free thyroxine or free thyroxine index); from 2008 onward, levothyroxine treatment prepregnancy to maintain TSH ≤2.5 mIU/L.Main outcome measure(s) Live-birth rate (LBR).Result(s) The prevalence of SCH was 55 (19%) of 286 in this REPL cohort. The cumulative LBR was 27 (69%) of 39 for women with SCH versus 104 (74%) of 141 for euthyroid women. The per-pregnancy LBR was 34 (49%) of 69 for SCH versus 129 (58%) of 221 for euthyroid women. When the LBR was compared between treated and untreated SCH, the cumulative LBR was 17 (71%) of 24 versus 10 (67%) of 15, respectively. The per-pregnancy LBR for SCH treated versus untreated women was 22 (48%) of 46 versus 12 (52%) of 23, respectively.Conclusion(s) Although there was a high prevalence of SCH in the REPL cohort, there was no statistically significant difference in the subsequent live-birth rate when comparing women with SCH and euthyroid women, or treated and untreated SCH.
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The incidence of subclinical hypothyroidism (TSH more than 2.5 mIU/l) has been reported to be raised in a small observational study of women with recurrent miscarriage.
“the incidence of subclinical hypothyroidism (SCH) (on this occasion defined as TSH more than 2.5 mIU/l) has been reported to be raised in a small observational study of women with recurrent miscarriage, 85”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [85]
The cohort study of Bernardi et al. (2013) in women with two or more miscarriages found no statistically significant difference in the subsequent live birth rate when comparing women with SCH versus euthyroid women, or treated and untreated women with SCH.
“However, in terms of studies in the recurrent miscarriage population, the cohort study of Bernardi et al. (2013) in women with two or more miscarriages, found no statistically significant difference in the subsequent live birth rate when comparing women with SCH versus euthyroid women, or treated and untreated women with SCH.85”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [85]
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- Authors
- Bernardi, L. A., Cohen, R. N., & Stephenson, M. D.
- Affiliations
- University of Illinois Chicago (US)
- University of Chicago (US)
- Corresponding author
- Stephenson, Mary D.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 100
- Issue
- 5
- Pages
- 1326-1331.e1
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2046078778
- Cited by
- 90
- References
- 32
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 8 · 2023: 6 · 2022: 7 · 2021: 12 · 2020: 8 · 2019: 6 · 2018: 6 · 2017: 9 · 2016: 10 · 2015: 5 · 2014: 7
- FWCI
- 5.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Illinois at Urbana-Champaign
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- subclinical hypothyroidism, recurrent early pregnancy loss, live birth rate, levothyroxine therapy, thyroid-stimulating hormone, thyroid function in pregnancy
- MeSH terms
- Abortion, Spontaneous, Abortion, Habitual, Academic Medical Centers, Adult, Chicago, Female, Gestational Age, Humans, Hypothyroidism, Pregnancy, Risk Factors, Thyrotropin, Thyroxine, Cohort Studies, Biomarkers, Prevalence, Chi-Square Distribution, Treatment Outcome, Hormone Replacement Therapy, Live Birth, Young Adult, Asymptomatic Diseases
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