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Cited by 88Thyroid Disorders and TreatmentsThyroid Cancer Diagnosis and TreatmentThyroid and Parathyroid Surgery

Pregnant Women on Thyroxine Substitution Are Often Dysregulated in Early Pregnancy

Hallengren, Bengt, Lantz, Mikael, Andreasson, Bengt, Grennert, Lars·2009·Thyroid
DOI 10.1089/thy.2008.0206
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Abstract

BACKGROUND: Thyroid hormones are important for normal fetal development. Maternal hypothyroidism during early pregnancy is associated with impaired neuropsychological development of children and other adverse outcomes. The primary aim of this prospective study was to determine whether thyroxine-treated pregnant women with hypothyroidism are adequately thyroxine substituted in early pregnancy. A secondary aim was to determine if fetal loss differed between females with thyrotropin (TSH) values within and outside the reference range at their first TSH test, scheduled for 1-2 weeks after verification of pregnancy. METHODS: This was a prospective open-labeled study. During the years 1997-2002, 119 consecutive pregnancies in 101 females with thyroid diseases were followed at the Department of Endocrinology, Malmö University Hospital. At the first visit, 63 patients, median age 30 years (range 17-45 years), were on thyroxine substitution therapy for hypothyroidism. In these patients 83% were in their first trimester at the time of the initial test. RESULTS: Of the 63 patients on thyroxine substitution for hypothyroidism 32 (51%; Group A) patients had serum TSH values within the reference range at their initial test and 31 (49%; Group B) had serum TSH values outside the reference range. Twelve (19%) had TSH values of <0.40 mIU=L and 19 (30%) had TSH values of >4.0 mIU=l. The fetal loss was 2 of 32 (6%) in Group A compared to 9 of 31 (29%) in Group B ( p < 0.05). CONCLUSIONS: In 49% of pregnant women on thyroxine substitution, serum TSH values were outside the reference range when first tested, generally in the first trimester. Fetal loss was significantly greater in pregnant women with abnormal TSH values compared to those with normal TSH values. Thyroid function in pregnant women on thyroxine substitution should be monitored early in pregnancy and carefully followed during pregnancy. The thyroxine dose should be increased as needed early in pregnancy to avoid hypothyroidism.

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Authors
Hallengren, B., Lantz, M., Andreasson, B., & Grennert, L.
Affiliations
  • Department of Endocrinology, Malmö University Hospital, Malmö, Sweden.
  • Department of Pediatrics, Malmö University Hospital, Malmö, Sweden.
  • Skåne University Hospital (SE)
Corresponding author
Hallengren, Bengt
ORCID
Venue
Thyroid
Publisher
SAGE Publications
Published
2009-04
Volume
19
Issue
4
Pages
391-394
ISSN
  • 1050-7256 (ISSN-L)
  • 1557-9077
DOI
10.1089/thy.2008.0206
OpenAlex
W2021455259
Cited by
88
References
18
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 9 · 2015: 9 · 2014: 12 · 2013: 7 · 2012: 2
FWCI
5.81
Type
journal article
Language
en
Open access
closed
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • Thyroid (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
maternal hypothyroidism, pregnancy, first trimester, thyroid-stimulating hormone, fetal death, thyroid function monitoring, dose adjustment, fetal development
MeSH terms
Adolescent, Adult, Female, Humans, Hypothyroidism, Pregnancy, Pregnancy Complications, Pregnancy Trimester, First, Prospective Studies, Thyrotropin, Thyroxine, Fetal Development

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