Assessment of Thyroid Function During First-Trimester Pregnancy: What Is the Rational Upper Limit of Serum TSH During the First Trimester in Chinese Pregnant Women?
Abstract
CONTEXT: Guidelines of the American Thyroid Association (ATA) proposed that the upper limit of the TSH reference range should be 2.5 mIU/L in first trimester, but the reported ranges in China are significantly higher. OBJECTIVE: Our objective was to establish a rational reference range of serum TSH for diagnosis of subclinical hypothyroidism in the first trimester of pregnant women in China. DESIGN: We screened 4800 pregnant women in the first trimester and 2000 women who planned to become pregnant and evaluated 535 pregnant women in follow-up visits during the second and third trimester. RESULTS: Median concentrations of serum TSH decreased significantly from the seventh week of gestation. The median of TSH from 4 to 6 weeks was significantly higher than from 7 to 12 weeks (2.15 [0.56-5.31] mIU/L vs 1.47 [0.10-4.34] mIU/L, P<.001); however, there was no significant difference compared with nonpregnant women (2.07 [0.69-5.64] mIU/L; P=.784). The median of free T4 was not significantly altered in the first trimester. The prevalence of subclinical hypothyroidism in the 4800 pregnant women was 27.8% on the diagnostic criteria of TSH>2.5 mIU/L and 4.0% using the reference interval derived by our laboratory (0.14-4.87 mIU/L).Additionally, of 118 pregnant women who had serum TSH>2.5 mIU/L in the first trimester, only 30.0% and 20.3% of them at the 20th and 30th week of gestation had TSH>3.0 mIU/L. CONCLUSIONS: The reference range for nonpregnant women can be used for the assessment of pregnant women at 4 to 6 weeks of gestation. The upper limit of serum TSH in the first trimester was much higher than 2.5 mIU/L in Chinese pregnant women.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Serum TSH levels may be below the nonpregnant reference range in the first half of a normal-term pregnancy, especially in gestational weeks 9-13.
“Serum TSH levels may be below the nonpregnant reference range in the first half of a normal-term pregnancy (435,436), and especially so in gestational weeks 9-13, during which a subset of pregnant women may develop a suppressed serum TSH (437-439).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [439]
Cites
Stagnaro-Green, A., Abalovich, M., Alexander, E., Azizi, F., Mestman, J., Negro, R., Nixon, A., Pearce, E. N., Soldin, O. P., Sullivan, S., et al. (2011) · Thyroid · doi:10.1089/thy.2011.0087 · Cited by 2,942 · see citing works
Haddow, J. E., Palomaki, G. E., Allan, W. C., Williams, J. R., Knight, G. J., Gagnon, J., O'Heir, C. E., Mitchell, M. L., Hermos, R. J., Waisbren, S. E., et al. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908193410801 · Cited by 2,558 · see citing works
The Clinical Significance of Subclinical Thyroid Dysfunction
Biondi, B., & Cooper, D. S. (2008) · Endocrine Reviews · doi:10.1210/er.2006-0043 · Cited by 1,418 · see citing works
Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease
(2003) · Thyroid · doi:10.1089/105072503321086962 · Cited by 1,212 · see citing works
Subclinical hypothyroidism and pregnancy outcomes
Casey, B. M., Dashe, J. S., Wells, C. E., McIntire, D. D., Byrd, W., Leveno, K. J., & Cunningham, F. G. (2005) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000152345.99421.22 · Cited by 903 · see citing works
Effect of Iodine Intake on Thyroid Diseases in China
Teng, W., Shan, Z., Teng, X., Guan, H., Li, Y., Teng, D., Jin, Y., Yu, X., Fan, C., Chong, W., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa054022 · Cited by 742 · see citing works
Self-citationRegulation of Maternal Thyroid during Pregnancy*
Glinoer, D., Nayer, P. D., Bourdoux, P. P., Lemone, M., Robyn, C., Steirteghem, A. V., KINTHAERT, J., & Lejeune, B. (1990) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-71-2-276 · Cited by 724 · see citing works
Antenatal Thyroid Screening and Childhood Cognitive Function
Lazarus, J. H., Bestwick, J. P., Channon, S., Paradice, R., Maina, A., Rees, R., Chiusano, E., John, R., Guaraldo, V., George, L. M., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1106104 · Cited by 635 · see citing works
Maternal Thyroid Hypofunction and Pregnancy Outcome
Cleary‐Goldman, J., Malone, F. D., Lambert-Messerlian, G. M., SULLIVAN, L. M., Canick, J. A., Porter, T. F., Luthy, D. A., Gross, S. J., Bianchi, D. W., & D’Alton, M. E. (2008) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181788dd7 · Cited by 518 · see citing works
Demers, L. M., & Spencer, C. A. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01681.x · Cited by 460 · see citing works
Negro, R., Schwartz, A., Gismondi, R., Tinelli, A., Mangieri, T., & Stagnaro‐Green, A. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0340 · Cited by 440 · see citing works
Benhadi, N., Wiersinga, W. M., Reitsma, J. B., Vrijkotte, T. G. M., & Bonsel, G. J. (2009) · European Journal of Endocrinology · doi:10.1530/eje-08-0953 · Cited by 325 · see citing works
Establishment of reference range for thyroid hormones in normal pregnant Indian women
Marwaha, R. K., Chopra, S., Gopalakrishnan, S., Sharma, B., Kanwar, R., Sastry, A. V. R., & Singh, S. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01673.x · Cited by 250 · see citing works
Reference intervals for thyroid hormones in pregnant Chinese women
Panesar, N. S., Li, C.-Y., & Rogers, M. S. (2001) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1258/0004563011900830 · Cited by 214 · see citing works
Self-citationReference values for clinical chemistry tests during normal pregnancy
Larsson, A. O., Palm, M., Hansson, L.-O., & Axelssön, O. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01709.x · Cited by 210 · see citing works
Teng, X., Shan, Z., Chen, Y., Lai, Y., Yu, J., Shan, L., Bai, X., Li, Y., Li, N., Li, Z., et al. (2011) · European Journal of Endocrinology · doi:10.1530/eje-10-1041 · Cited by 173 · see citing works
Self-citationNational Status of Testing for Hypothyroidism during Pregnancy and Postpartum
Blatt, A. J., Nakamoto, J. M., & Kaufman, H. W. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2038 · Cited by 170 · see citing works
Subclinical Hypothyroidism and Pregnancy Outcomes
Casey, B. M., Dashe, J. S., Wells, C. E., McIntire, D. D., Leveno, K. J., & Cunningham, F. G. (2005) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000169597.61122.be · Cited by 154 · see citing works
Maternal Early Pregnancy and Newborn Thyroid Hormone Parameters: The Generation R Study
Medici, M., de Rijke, Y. B., Peeters, R. P., Visser, W. E., Keizer‐Schrama, S. M. P. F. D. M., Jaddoe, V. V. W., Albert Hofman, D., Hooijkaas, H., Steegers, E. A. P., Tiemeier, H. W., et al. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-2398 · Cited by 152 · see citing works
Männistö, T. I., Surcel, H., Ruokonen, A., Vääräsmäki, M., Pouta, A. M., Bloigu, A. H., Järvelin, M., Hartikainen, A., & Suvanto, E. T. J. (2011) · Thyroid · doi:10.1089/thy.2010.0337 · Cited by 147 · see citing works
Pearce, E. N., Oken, E., Gillman, M. W., Lee, S. L., Magnani, B., Platek, D., & Braverman, L. E. (2008) · Endocrine Practice · doi:10.4158/ep.14.1.33 · Cited by 136 · see citing works
Yan, Y.-Q., Dong, Z., Dong, L., Wang, F., Yang, X.-M., Jin, X., Lin, L.-X., Sun, Y., & Zu-pei, C. (2010) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2010.03910.x · Cited by 119 · see citing works
Second-Trimester Reference Intervals for Thyroid Tests: The Role of Ethnicity
La’ulu, S. L., & Roberts, W. L. (2007) · Clinical Chemistry · doi:10.1373/clinchem.2007.089680 · Cited by 110 · see citing works
Laboratory Medicine Practice Guidelines
(2014) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2014-4037 · Cited by 102 · see citing works
Gilbert, R. M., Hadlow, N. C., Walsh, J. P., Fletcher, S. J., Brown, S. J., Stuckey, B. G. A., & Lim, E. M. (2008) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2008.tb02015.x · Cited by 98 · see citing works
Haddow, J. E., McClain, M. R., Lambert-Messerlian, G. M., Palomaki, G. E., Canick, J. A., Cleary‐Goldman, J., Malone, F. D., Porter, T. F., Nyberg, D. A., Bernstein, P. S., et al. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-0568 · Cited by 92 · see citing works
Maternal Thyroid Hypofunction and Pregnancy Outcome
Cleary‐Goldman, J., Malone, F. D., Lambert-Messerlian, G. M., SULLIVAN, L. M., Canick, J. A., Porter, T. F., Luthy, D. A., Gross, S. J., Bianchi, D. W., & D’Alton, M. E. (2009) · Obstetric Anesthesia Digest · doi:10.1097/01.aoa.0000350632.42302.43 · Cited by 83 · see citing works
A study for maternal thyroid hormone deficiency during the first half of pregnancy in China
Shan, Z., Chen, Y. Y., Teng, W., Yu, X., Li, C. Y., Zhou, W., Gao, B., Zhou, J. R., Ding, B., Ma, Y., et al. (2008) · European Journal of Clinical Investigation · doi:10.1111/j.1365-2362.2008.02055.x · Cited by 77 · see citing works
Self-citationBoas, M., Forman, J. L., Juul, A., Feldt-Rasmussen, U., Skakkebæk, N. E., Hilsted, L., Chellakooty, M., Larsen, T., Larsen, J. F., Petersen, J. H., et al. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0579 · Cited by 74 · see citing works
Cotzias, C. S., Wong, S.-J., Taylor, E., Seed, P. T., & Girling, J. (2008) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2007.10.007 · Cited by 68 · see citing works
Dhatt, G. S., Jayasundaram, R., Wareth, L. A., Nagelkerke, N. J. D., Jayasundaram, K., Darwish, E. A., & Lewis, A. (2006) · Clinica Chimica Acta · doi:10.1016/j.cca.2006.02.008 · Cited by 56 · see citing works
The Debate over Thyroid-Function Screening in Pregnancy
Brent, G. A. (2012) · New England Journal of Medicine · doi:10.1056/nejme1112591 · Cited by 54 · see citing works
Establishment of the Trimester-Specific Reference Range for Free Thyroxine Index
Azizi, F., Mehran, L., Amouzegar, A., Delshad, H., Tohidi, M., Askari, S., & Hedayati, M. (2012) · Thyroid · doi:10.1089/thy.2012.0407 · Cited by 52 · see citing works
Antenatal Thyroid Screening and Childhood Cognitive Function
Eugster, E. A. (2012) · Yearbook of Endocrinology · doi:10.1016/j.yend.2012.03.006 · Cited by 47 · see citing works
Reference Values for Thyroid Function Tests in Pregnant Women Living in Catalonia, Spain
Vila, L., Serra‐Prat, M., Palomera, E., Casamitjana, R., de Castro, A., Legaz, G., Barrionuevo, C., Garcia, A.-J., Lal-Trehan, S., Muñoz, J. A., et al. (2010) · Thyroid · doi:10.1089/thy.2008.0264 · Cited by 44 · see citing works
Li, C., Guan, H., Teng, X., Lai, Y., Chen, Y., Yu, J., Li, N., Wang, B., Jiang, F., Wang, J., et al. (2011) · Endocrine Journal · doi:10.1507/endocrj.k11e-101 · Cited by 38 · see citing works
Self-citationNational Status of Testing for Hypothyroidism During Pregnancy and Postpartum
Blatt, A. J., Nakamoto, J. M., & Kaufman, H. W. (2012) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0b013e31825de76c · Cited by 14 · see citing works
Jia, L., Teng, W., Zhongyan, S., Li, C., Zhou, W., Gao, B., Shang, T., Zhou, J., Bing, D., Ma, Y., et al. (2008) · Zhonghua neifenmi daixie zazhi · Cited by 8 · see citing works
Self-citationMaternal Thyroid Hypofunction and Pregnancy Outcome
Blumenfeld, Z. (2008) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181907811 · Cited by 4 · see citing works
Luo, J., Han, M., Song, M., Khor, Z. S., & Fan, J. (2012) · Zhonghua weichan yixue zazhi · doi:10.3760/cma.j.issn.1007-9408.2012.07.002 · Cited by 2 · see citing works
薛海波, 李元宾, 滕卫平, 单忠艳, 于晓会, 李玉姝, 王薇薇, 陈彦彦, 李佳, 关海霞, et al. (2010) · Zhonghua neifenmi daixie zazhi · doi:10.3760/cma.j.issn.1000-6699.2010.11.002 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
Alexander, E. K., Pearce, E. N., Brent, G. A., Brown, R. S., Chen, H., Dosiou, C., Grobman, W. A., Laurberg, P., Lazarus, J. H., Mandel, S. J., et al. (2017) · Thyroid® · doi:10.1089/thy.2016.0457 · Cited by 2,731 · see citing works
Jonklaas, J., Bianco, A. C., Bauer, A. J., Burman, K. D., Cappola, A. R., Celi, F. S., Cooper, D. S., Kim, B. W., Peeters, R. P., Rosenthal, M. S., et al. (2014) · Thyroid® · doi:10.1089/thy.2014.0028 · Cited by 1,928 · see citing works
Lazarus, J., Brown, R. S., Daumerie, C., Hubalewska-Dydejczyk, A., Negro, R., & Vaidya, B. (2014) · European Thyroid Journal · doi:10.1159/000362597 · Cited by 742 · see citing works
Thyroid disease in pregnancy: new insights in diagnosis and clinical management
Korevaar, T. I. M., Medici, M., Visser, T. J., & Peeters, R. P. (2017) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.93 · Cited by 441 · see citing works
Shi, X., Han, C., Li, C., Mao, J., Wang, W., Xie, X., Li, C., Xu, B., Meng, T., Du, J., et al. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3704 · Cited by 239 · see citing works
Self-citationAssessment and treatment of thyroid disorders in pregnancy and the postpartum period
Lee, S. Y., & Pearce, E. N. (2022) · Nature Reviews Endocrinology · doi:10.1038/s41574-021-00604-z · Cited by 225 · see citing works
Thyroid Function in Pregnancy: What Is Normal?
Medici, M., Korevaar, T. I. M., Visser, W. E., Visser, T. J., & Peeters, R. P. (2015) · Clinical Chemistry · doi:10.1373/clinchem.2014.236646 · Cited by 191 · see citing works
Thyroid in pregnancy: From physiology to screening
Springer, D., Jiskra, J., Limanova, Z., Zima, T., & Potluková, E. (2017) · Critical Reviews in Clinical Laboratory Sciences · doi:10.1080/10408363.2016.1269309 · Cited by 185 · see citing works
Molecular basis of thyrotropin and thyroid hormone action during implantation and early development
Colicchia, M., Campagnolo, L., Baldini, E., Ulisse, S., Valensise, H. C. C., & Moretti, C. (2014) · Human Reproduction Update · doi:10.1093/humupd/dmu028 · Cited by 185 · see citing works
Diagnosis and management of subclinical hypothyroidism in pregnancy
Negro, R., & Stagnaro‐Green, A. (2014) · BMJ · doi:10.1136/bmj.g4929 · Cited by 166 · see citing works
Zhang, Y., Wang, H., Pan, X., Teng, W., & Shan, Z. (2017) · PLOS ONE · doi:10.1371/journal.pone.0175708 · Cited by 143 · see citing works
Self-citationEffects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism
Maraka, S., Ospina, N. S., O'Keeffe, D. T., Rodríguez‐Gutiérrez, R., Ycaza, A. E. E. D., Wi, C., Juhn, Y. J., Coddington, C. C., Montori, V. M., & Stan, M. N. (2016) · Thyroid · doi:10.1089/thy.2016.0014 · Cited by 118 · see citing works
Chan, S., & Boelaert, K. (2014) · Clinical Endocrinology · doi:10.1111/cen.12605 · Cited by 117 · see citing works
Ying, H., Tang, Y., Bao, Y., Su, X., Cai, X., Li, Y., & Wang, D. (2016) · Endocrine · doi:10.1007/s12020-016-1022-6 · Cited by 97 · see citing works
Levothyroxine treatment of mild subclinical hypothyroidism: a review of potential risks and benefits
Javed, Z., & Sathyapalan, T. (2015) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018815616543 · Cited by 91 · see citing works
Testing, Monitoring, and Treatment of Thyroid Dysfunction in Pregnancy
Lee, S. Y., & Pearce, E. N. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa945 · Cited by 94 · see citing works
Yu, X., Shan, Z., Li, C., Mao, J., Wang, W., Xie, X., Liu, A., Teng, X., Zhou, W., Li, C., et al. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3887 · Cited by 87 · see citing works
Self-citationLaurberg, P., Andersen, S. L., Hindersson, P., Nohr, E. A., & Olsen, J. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-1387 · Cited by 81 · see citing works
Li, C., Peng, S., Zhang, X., Xie, X., Wang, D., Mao, J., Teng, X., Shan, Z., & Teng, W. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-3519 · Cited by 81 · see citing works
Self-citationThyroid function and thyroid disorders during pregnancy: a review and care pathway
Delitala, A., Capobianco, G., Cherchi, P. L., Dessole, S., & Delitala, G. (2018) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-018-5018-8 · Cited by 74 · see citing works
Maraka, S., Singh Ospina, N. M., Mastorakos, G., & O’Keeffe, D. T. (2018) · Journal of the Endocrine Society · doi:10.1210/js.2018-00090 · Cited by 73 · see citing works
Andersen, S. L., Carlé, A., Karmisholt, J., Pedersen, I. B., & Andersen, S. (2017) · European Journal of Endocrinology · doi:10.1530/eje-16-0947 · Cited by 68 · see citing works
Heppner, K. M., & Tong, J. (2014) · European Journal of Endocrinology · doi:10.1530/eje-14-0183 · Cited by 66 · see citing works
Preconception TSH and pregnancy outcomes: a population‐based cohort study in 184 611 women
Chen, S., Zhou, X., Zhu, H., Yang, H., Gong, F., Wang, L., Zhang, M., Jiang, Y., Yan, C., Li, J., et al. (2017) · Clinical Endocrinology · doi:10.1111/cen.13329 · Cited by 69 · see citing works
Self-citationYamamoto, J. M., Benham, J. L., Nerenberg, K. A., & Donovan, L. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022837 · Cited by 62 · see citing works
Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape
Yoo, W. S., & Chung, H. K. (2021) · Endocrinology and Metabolism · doi:10.3803/enm.2021.1066 · Cited by 72 · see citing works
Reporting Thyroid Function Tests in Pregnancy.
McNeil, A. R., & Stanford, P. E. (2015) · Europe PMC (PubMed Central) · Cited by 56 · see citing works
Litwicka, K., Arrivi, C., Varricchio, M. T., Mencacci, C., & Greco, E. (2014) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.12615 · Cited by 54 · see citing works
Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic
López-Muñoz, E., Mateos-Sánchez, L., Mejía-Terrazas, G. E., & Bedwell-Cordero, S. E. (2019) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2019.09.005 · Cited by 52 · see citing works
Are we overtreating subclinical hypothyroidism in pregnancy?
Wiles, K., Jarvis, S., & Nelson‐Piercy, C. (2015) · BMJ · doi:10.1136/bmj.h4726 · Cited by 50 · see citing works
SULLIVAN, S. A. (2019) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000432 · Cited by 50 · see citing works
Kent, N. L., Young, S. L., Akison, L. K., & Cuffe, J. S. M. (2021) · Endocrine · doi:10.1007/s12020-021-02733-x · Cited by 46 · see citing works
Management of overt hypothyroidism during pregnancy
Li, S. W., & Chan, S. (2020) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2020.101439 · Cited by 46 · see citing works
Pregnancy Complications Associated With Maternal Hypothyroidism: A Systematic Review
Shinohara, D. R., Santos, T. D. S., de Carvalho, H. C., Lopes, L. C. B., Günther, L. S. A., Aristides, S. M. A., Teixeira, J. J. V., & Demarchi, I. G. (2018) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0000000000000547 · Cited by 46 · see citing works
Pregnancy and postpartum dynamics revealed by millions of lab tests
Bar, A., Moran, R., Cohen, N. M., Kohanim, Y. K., Mayo, A., Toledano, Y., & Alon, U. S. (2025) · Science Advances · doi:10.1126/sciadv.adr7922 · Cited by 46 · see citing works
Two-Years Prospective Follow-Up Study of Subacute Thyroiditis
Zhao, N., Wang, S., Cui, X., Huang, M., Wang, S., Li, Y.-G., Zhao, L., Wan, W., Li, Y.-S., Shan, Z., et al. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.00047 · Cited by 45 · see citing works
Self-citationBohn, M. K., & Adeli, K. (2021) · Critical Reviews in Clinical Laboratory Sciences · doi:10.1080/10408363.2021.1978923 · Cited by 42 · see citing works
Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies
Velasco, I., & Taylor, P. N. (2017) · European Journal of Endocrinology · doi:10.1530/eje-17-0598 · Cited by 41 · see citing works
ENDOCRINOLOGY IN PREGNANCY: Pregnancy and the incidence, diagnosing and therapy of Graves’ disease
Laurberg, P., & Andersen, S. L. (2016) · European Journal of Endocrinology · doi:10.1530/eje-16-0410 · Cited by 42 · see citing works
Hou, Y., Liu, A., Li, J., Wang, H., Yang, Y., Li, Y., Fan, C., Zhang, H., Wang, H., Ding, S., et al. (2019) · Thyroid · doi:10.1089/thy.2018.0097 · Cited by 40 · see citing works
Self-citationRotondi, M., Chiovato, L., Pacini, F., Bartalena, L., & Vitti, P. (2018) · Thyroid · doi:10.1089/thy.2017.0424 · Cited by 39 · see citing works
Management of subclinical hypothyroidism in pregnancy: are we too simplistic?
Brabant, G. E., Peeters, R. P., Chan, S., Bernal, J., Bouchard, P., Salvatore, D., Boelaert, K., & Laurberg, P. (2015) · European Journal of Endocrinology · doi:10.1530/eje-14-1005 · Cited by 38 · see citing works
Andersen, S. L., Andersen, S., Carlé, A., Christensen, P. A., Handberg, A., Karmisholt, J., Knøsgaard, L., Kristensen, S. R., Pedersen, I. B., & Vestergaard, P. (2019) · Thyroid · doi:10.1089/thy.2018.0628 · Cited by 37 · see citing works
Zhang, X., Yao, B., Li, C., Mao, J., Wang, W., Xie, X., Teng, X., Han, C., Zhou, W., Li, C., et al. (2016) · Thyroid · doi:10.1089/thy.2016.0002 · Cited by 36 · see citing works
Self-citationHan, L., Zheng, W., Zhai, Y., Xie, X., Zhang, J., Zhang, S., Zhao, Z., & Cao, Z. (2017) · Journal of Clinical Laboratory Analysis · doi:10.1002/jcla.22344 · Cited by 36 · see citing works
Self-citationEarly pregnancy thyroid hormone reference ranges in Chilean women: the influence of body mass index
Mosso, L. M., Martínez, A., Rojas, M. P., Latorre, G., Margozzini, P., Lyng, T., Jorge Carvajal, C., Campusano, C., Arteaga, E., & Boucai, L. (2016) · Clinical Endocrinology · doi:10.1111/cen.13127 · Cited by 35 · see citing works
Liu, J., Yu, X., Xia, M., Cai, H., Cheng, G., Wu, L., Li, Q., Zhang, Y., Sheng, M., Liu, Y., et al. (2016) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2016.11.036 · Cited by 35 · see citing works
Si, S., Shen, Y., Xin, X., Mo, M., Shao, B., Wang, S., Luo, W., Chen, Z., Liu, H., Chen, D., et al. (2020) · Journal of Diabetes · doi:10.1111/1753-0407.13101 · Cited by 33 · see citing works
Labadzhyan, A., Brent, G. A., Hershman, J. M., & Leung, A. M. (2014) · Journal of Clinical & Translational Endocrinology · doi:10.1016/j.jcte.2014.07.008 · Cited by 33 · see citing works
Teng, X., Shan, Z., Li, C., Yu, X., Mao, J., Wang, W., Xie, X., Du, J., ShaoWei, Z., Gao, Z., et al. (2018) · Thyroid · doi:10.1089/thy.2017.0491 · Cited by 32 · see citing works
Self-citationThyroid hormone therapy of hypothyroidism in pregnancy
Shan, Z., & Teng, W. (2019) · Endocrine · doi:10.1007/s12020-019-02044-2 · Cited by 28 · see citing works
Self-citationGestational TSH and FT4 Reference Intervals in Chinese Women: A Systematic Review and Meta-Analysis
Gao, X., Li, Y., Li, J., Liu, A., Sun, W., Teng, W., & Shan, Z. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00432 · Cited by 30 · see citing works
Self-citationOllero, M. D., Toni, M., Pineda, J. J., Martínez, J. P., Espada, M., & Anda, E. (2019) · Thyroid · doi:10.1089/thy.2018.0324 · Cited by 30 · see citing works
Evaluating thyroid function in pregnant women
Geno, K. A., & Nerenz, R. D. (2022) · Critical Reviews in Clinical Laboratory Sciences · doi:10.1080/10408363.2022.2050182 · Cited by 30 · see citing works
Zhang, H.-Y., Teng, X., Shan, Z., Wang, Z., Li, C., Yu, X., Mao, J., Wang, W., Xie, X., & Teng, W. (2019) · Chinese Medical Journal · doi:10.1097/cm9.0000000000000409 · Cited by 30 · see citing works
Self-citationBliddal, S., Boas, M., Hilsted, L., Friis-Hansen, L. J., Tabor, A., & Feldt‐Rasmussen, U. (2015) · European Journal of Endocrinology · doi:10.1530/eje-15-0358 · Cited by 29 · see citing works
Update on the Management of Thyroid Disease during Pregnancy
Yim, C. H. (2016) · Endocrinology and Metabolism · doi:10.3803/enm.2016.31.3.386 · Cited by 30 · see citing works
Management of thyrotoxicosis during pregnancy
Andersen, S. L., & Knøsgaard, L. (2020) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2020.101414 · Cited by 28 · see citing works
Li, M.-F., Ma, L., Feng, Q.-M., Zhu, Y., Yu, T.-P., Ke, J.-F., Zhang, Z.-H., Liu, Y., & Li, L.-X. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.580380 · Cited by 27 · see citing works
Osinga, J. A. J., Derakhshan, A., Feldt-Rasmussen, U., Huang, K., Vrijkotte, T. G. M., Männistö, T., Bassols, J., López-Bermejo, A., Aminorroaya, A., Vafeiadi, M., et al. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad564 · Cited by 27 · see citing works
Method-dependent variation in TSH and FT4 reference intervals in pregnancy: A systematic review
Okosieme, O. E., Agrawal, M., Usman, D., & Evans, C. (2021) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/00045632211026955 · Cited by 27 · see citing works
Yang, X., Meng, Y., Zhang, Y., Zhang, C., Guo, F., Yang, S., Ding, R., & Fan, J. (2019) · Chinese Medical Journal · doi:10.1097/cm9.0000000000000051 · Cited by 27 · see citing works
Thyroid stimulating hormone (TSH) ≥2.5mU/l in early pregnancy: Prevalence and subsequent outcomes
Carty, D., Doogan, F., Welsh, P. I., Dominiczak, A. F., & Delles, C. (2017) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2017.01.048 · Cited by 26 · see citing works
The upper limit for TSH during pregnancy: why we should stop using fixed limits of 2.5 or 3.0 mU/l
Korevaar, T. I. M. (2018) · Thyroid Research · doi:10.1186/s13044-018-0048-7 · Cited by 25 · see citing works
Maternal Thyroid Dysfunction and Gestational Anemia Risk: Meta-Analysis and New Data
Yang, Y., Hou, Y., Wang, H., Gao, X., Wang, X., Li, J., Teng, W., & Shan, Z. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.00201 · Cited by 24 · see citing works
Self-citationZhang, X., Li, C., Mao, J., Wang, W., Xie, X., Peng, S., Wang, Z., Han, C., Zhang, X., Wang, D., et al. (2016) · Clinical Endocrinology · doi:10.1111/cen.13175 · Cited by 24 · see citing works
Self-citationRosário, P. W., Carvalho, M. U. W. B. D., & Calsolari, M. R. (2016) · Archives of Endocrinology and Metabolism · doi:10.1590/2359-3997000000132 · Cited by 23 · see citing works
Turkal, R., Armağan, T. C., Elbasan, O., Aytan, S., Çakmak, B. D., Gozaydınoğlu, B., Ceyda, T. D., Ünlü, O., Bahramzada, G., Tekin, A. F., et al. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04608-z · Cited by 23 · see citing works
Should All Women Be Screened for Thyroid Dysfunction in Pregnancy?
Taylor, P. N., Okosieme, O. E., Premawardhana, L. D. K. E., & Lazarus, J. H. (2015) · Women s Health · doi:10.2217/whe.15.7 · Cited by 23 · see citing works
Reference intervals of thyroid hormones during pregnancy in Korea, an iodine-replete area
Kim, H. J., Cho, Y. Y., Kim, S. W., Kim, T. H., Jang, H. W., Lee, S., Choi, S., Roh, C., Kim, J., Chung, J. H., et al. (2017) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2016.051 · Cited by 23 · see citing works
Li, P., Lin, S., Li, L., Cui, J., Zhou, S., & Fan, J. (2018) · BMC Endocrine Disorders · doi:10.1186/s12902-018-0294-7 · Cited by 23 · see citing works
Li, J., Liu, A., Liu, H., Li, C., Wang, W., Han, C., Wang, X., Zhang, Y., Teng, W., & Shan, Z. (2019) · Endocrine Connections · doi:10.1530/ec-19-0316 · Cited by 23 · see citing works
Self-citationCurrent challenges in the pharmacological management of thyroid dysfunction in pregnancy
Khan, I. N., Okosieme, O. E., & Lazarus, J. H. (2016) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2017.1253471 · Cited by 23 · see citing works
Fu, J., Yang, A., Zhao, J. Y., Zhu, Y., Gu, Y., Xu, Y. G., & Chen, D. (2017) · Journal of Trace Elements in Medicine and Biology · doi:10.1016/j.jtemb.2017.01.004 · Cited by 21 · see citing works
Yamamoto, J. M., Metcalfe, A., Nerenberg, K. A., Khurana, R., Chin, A., & Donovan, L. (2020) · Canadian Medical Association Journal · doi:10.1503/cmaj.191664 · Cited by 21 · see citing works
Illouz, F., Luton, D., Polak, M., Besançon, A., & Bournaud, C. (2018) · Annales d Endocrinologie · doi:10.1016/j.ando.2018.08.004 · Cited by 20 · see citing works
Wang, X., Li, Y., Zhai, X., Wang, H., Zhang, F., Gao, X., Liu, S., Teng, W., & Shan, Z. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.660277 · Cited by 19 · see citing works
Self-citationLin, H., Ye, M., Zhou, Z., Yuan, L., Lash, G. E., Zhang, G., & Li, L. (2020) · Bioscience Reports · doi:10.1042/bsr20202296 · Cited by 21 · see citing works
Jaiswal, N., Melse‐Boonstra, A., Thomas, T. S., Basavaraj, C., Sharma, S. K., Srinivasan, K., & Zimmermann, M. B. (2014) · Thyroid · doi:10.1089/thy.2014.0071 · Cited by 19 · see citing works
“Hypothyroidism screening during first trimester of pregnancy”
Lara, M. C., Sánchez, Á. V., Cañavate-Solano, C., Pazos, E. S., Álvarez, M. I., Macías, C. G., Ortega, C. A., Corral, L. J. M., & Alba, J. J. F. (2017) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-017-1624-x · Cited by 19 · see citing works
de Morais, N. A. D. O. E. S., de Assis, A. S. A., Corcino, C. M., Saraiva, D. A., Berbara, T. M. B. L., Ventura, C. D. D. D., Vaisman, M., & Teixeira, P. D. F. D. S. (2018) · Archives of Endocrinology and Metabolism · doi:10.20945/2359-3997000000064 · Cited by 19 · see citing works
Reference ranges for TSH and thyroid hormones
Lewandowski, K. C. (2015) · Thyroid Research · doi:10.1186/1756-6614-8-s1-a17 · Cited by 19 · see citing works
Stagnaro‐Green, A., Dogo-Isonaige, E., Pearce, E. N., Spencer, C. A., & Gaba, N. D. (2015) · Thyroid · doi:10.1089/thy.2015.0063 · Cited by 18 · see citing works
Reproductive Endocrinology in Recurrent Pregnancy Loss
Krog, M. C., Nielsen, H. S., Christiansen, O. B., & Kolte, A. M. (2016) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000225 · Cited by 18 · see citing works
Toloza, F. J. K., Ospina, N. S., Rodríguez‐Gutiérrez, R., O'Keeffe, D. T., Brito, J. P., Montori, V. M., & Maraka, S. (2019) · Journal of the Endocrine Society · doi:10.1210/js.2019-00196 · Cited by 17 · see citing works
Castillo, C., Nicole Lustig, F., Margozzini, P., Gómez, A., Rojas, M. P., MUZZO, S., & Mosso, L. M. (2018) · Endocrinology and Metabolism · doi:10.3803/enm.2018.33.4.466 · Cited by 17 · see citing works
Wang, Z., Li, C., Teng, Y., Yun-ping, G., Zhang, L., Jia, X., Cui, D., Li, J., & Guan, H. (2020) · Biological Trace Element Research · doi:10.1007/s12011-020-02032-y · Cited by 17 · see citing works
Self-citationAcute painful crises may be causes of sudden deaths in sickle cell diseases
Helvacı, M. R., Camlibel, M., Yuksek, B. C., Sevinç, A., Camcı, C., Abyad, A., & Pocock, L. (2023) · World Family Medicine Journal/Middle East Journal of Family Medicine · doi:10.5742/mewfm.2023.95256109 · Cited by 16 · see citing works
Ghosh, S. K., Pramanik, S., Mukhopadhyay, P., Bhattacharjee, K., Bhattacharjee, R., Mukherjee, B., Mondal, S., Bandhopadhay, S., Biswas, S., & Chowdhury, S. (2020) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/ijem.ijem_561_19 · Cited by 16 · see citing works
Valores de referencia y cribado universal de la disfunción tiroidea en la mujer gestante
Díaz-Soto, G., Largo, E., Álvarez-Colomo, C., Martínez‐Pino, I., & de Luis, D. A. (2014) · Endocrinología y Nutrición · doi:10.1016/j.endonu.2014.03.002 · Cited by 16 · see citing works
Frequency and outcomes of maternal thyroid function abnormalities in early pregnancy
Andersen, S. L. (2019) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365513.2018.1555858 · Cited by 17 · see citing works
Tuncay, G., Karaer, A., Çoşkun, E. İ., Baloğlu, D., & Tecellioglu, N. (2018) · BMC Women s Health · doi:10.1186/s12905-018-0541-0 · Cited by 17 · see citing works
Yuen, L. Y., Chan, M. H. M., Sahota, D. S., Lit, L. C. W., Ho, C. S., Ronald, C. W., & Tam, W. H. (2020) · Thyroid · doi:10.1089/thy.2019.0323 · Cited by 15 · see citing works
Influence of SARS-CoV-2 infection on thyroid gland function: The current knowledge
Zgorzalewicz-Stachowiak, M., Czarnywojtek, A., Ochmańska, A., Sawicka‐Gutaj, N., Matyjaszek‐Matuszek, B., Woźniak, M., & Ruchała, M. (2021) · Advances in Clinical and Experimental Medicine · doi:10.17219/acem/139622 · Cited by 15 · see citing works
Reference and Influential Factors of Serum Bone Markers in Chinese Adolescents
Wang, X., Liu, L., Li, P., Ma, J., Jiang, R., Wang, R., Li, L., & Guan, H. (2017) · Scientific Reports · doi:10.1038/s41598-017-17670-x · Cited by 15 · see citing works
Zhu, P., Chu, R., Pan, S., Lai, X., Ran, J., & Li, X. (2021) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/20420188211054690 · Cited by 14 · see citing works
Donovan, L., Metcalfe, A., Chin, A., Yamamoto, J. M., Virtanen, H., Johnson, J.-A., & Krause, R. D. (2018) · Thyroid · doi:10.1089/thy.2018.0439 · Cited by 14 · see citing works
Li, P., Lin, S., Cui, J., Chen, X., Meng, Z., & Fan, J. (2021) · Journal of Women s Health · doi:10.1089/jwh.2020.8825 · Cited by 13 · see citing works
Han, L., Ma, Y., Liang, Z., & Chen, D. (2021) · Bioengineered · doi:10.1080/21655979.2021.1955589 · Cited by 13 · see citing works
- Authors
- Li, C., Shan, Z., Mao, J., Wang, W., Xie, X., Zhou, W., Li, C., Xu, B., Bi, L., Meng, T., Du, J., Zhang, S., Gao, Z., Zhang, X., Yang, L., Fan, C., & Teng, W.
- Affiliations
- First Hospital of China Medical University (CN)
- Shenyang Women and Infants Hospital (CN)
- First Affiliated Hospital of Dalian Medical University (CN)
- Chinese People's Liberation Army (CN)
- Dalian Medical University (CN)
- Corresponding author
- Shan, Zhongyan
- Teng, Weiping
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-01
- Volume
- 99
- Issue
- 1
- Pages
- 73-79
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2117905484
- Cited by
- 249
- References
- 41
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 45 · 2022: 19 · 2021: 24 · 2020: 20 · 2019: 22 · 2018: 26 · 2017: 25 · 2016: 20 · 2015: 18 · 2014: 12
- FWCI
- 13.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- China Medical University
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- thyroid function in pregnancy, first trimester, serum TSH, reference values, subclinical hypothyroidism, free thyroxine, Chinese pregnant women
- MeSH terms
- Adolescent, Adult, China, Female, Humans, Hypothyroidism, Mass Screening, Middle Aged, Pregnancy, Pregnancy Complications, Pregnancy Trimester, First, Prenatal Diagnosis, Reference Values, Thyroid Function Tests, Thyrotropin, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
