Cited by 358Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryMaternal Mental Health During Pregnancy and Postpartum

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Subclinical Hyperthyroidism and Pregnancy Outcomes

Casey, Brian M., Dashe, Jodi S., Wells, C Edward, McIntire, Donald D., Leveno, Kenneth J., Cunningham, F Gary·2006·Obstetrics & Gynecology

DOI 10.1097/01.aog.0000197991.64246.9a

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Abstract

OBJECTIVE: Subclinical hyperthyroidism has long-term sequelae that include osteoporosis, cardiovascular morbidity, and progression to overt thyrotoxicosis or thyroid failure. The objective of this study was to evaluate pregnancy outcomes in women with suppressed thyroid-stimulating hormone (TSH) and normal free thyroxine (fT(4)) levels. METHODS: All women who presented to Parkland Hospital for prenatal care between November 1, 2000, and April 14, 2003, underwent thyroid screening by chemiluminescent TSH assay. Women with TSH values at or below the 2.5th percentile for gestational age and whose serum fT(4) levels were 1.75 ng/dL or less were identified to have subclinical hyperthyroidism. Those women screened and delivered of a singleton infant weighing 500 g or more were analyzed. Pregnancy outcomes in women identified with subclinical hyperthyroidism were compared with those in women whose TSH values were between the 5th and 95th percentiles. RESULTS: A total of 25,765 women underwent thyroid screening and were delivered of singleton infants. Of these, 433 (1.7%) were considered to have subclinical hyperthyroidism, which occurred more frequently in African-American and/or parous women. Pregnancies in women with subclinical hyperthyroidism were less likely to be complicated by hypertension (adjusted odds ratio 0.66, 95% confidence interval 0.44-0.98). All other pregnancy complications and perinatal morbidity or mortality were not increased in women with subclinical hyperthyroidism. CONCLUSION: Subclinical hyperthyroidism is not associated with adverse pregnancy outcomes. Our results indicate that identification of subclinical hyperthyroidism and treatment during pregnancy is unwarranted. LEVEL OF EVIDENCE: II-2.

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Authors: Casey, B. M., Dashe, J. S., Wells, C. E., McIntire, D. D., Leveno, K. J., & Cunningham, F. G.
Affiliations: The University of Texas Southwestern Medical Center (US)
ORCID: Casey, Brian M.
Dashe, Jodi S.
Wells, C Edward
McIntire, Donald D.
Cunningham, F Gary
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2006-02
Volume: 107
Issue: 2, Part 1
Pages: 337-341
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1097/01.aog.0000197991.64246.9a
OpenAlex: W1983381211
Cited by: 358
References: 26
Citations by year: 2026: 7 · 2025: 9 · 2024: 7 · 2023: 15 · 2022: 23 · 2021: 20 · 2020: 13 · 2019: 22 · 2018: 18 · 2017: 13 · 2016: 28 · 2015: 20 · 2014: 18 · 2013: 24 · 2012: 22
FWCI: 11.09
Type: journal article
Language: en
Open access: closed
Locations: Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords: subclinical hyperthyroidism, pregnancy outcomes, thyroid-stimulating hormone, free thyroxine, gestational age, hypertension in pregnancy, perinatal morbidity, African American women, parous women
MeSH terms: Adult, Female, Humans, Hyperthyroidism, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Thyrotropin, Prevalence

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