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Cited by 249Thyroid Disorders and TreatmentsClinical Laboratory Practices and Quality ControlThyroid Cancer Diagnosis and Treatment

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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?

Li, Chenyan, Shan, Zhongyan, Mao, Jinyuan, Wang, Weiwei, Xie, Xiaochen, Zhou, Weiwei, Li, Chenyang, Xu, Bin, Bi, Lihua, Meng, Tao, Du, Jianling, Zhang, Shaowei, Gao, Zhengnan, Zhang, Xiaomei, Yang, Liu, Fan, Chenling, Teng, Weiping·2014·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2013-1674
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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.

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Metadata

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
DOI
10.1210/jc.2013-1674
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 › Health Professions › Medical Laboratory Technology › 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

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