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Cited by 10Gestational Diabetes Research and ManagementThyroid Disorders and TreatmentsGrowth Hormone and Insulin-like Growth Factors

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Can Thyroid Screening in the First Trimester Improve the Prediction of Gestational Diabetes Mellitus?

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Milovanović, Zagorka, Filimonović, Dejan, Soldatović, Ivan, Karadžov Orlić, Nataša·2022·Journal of Clinical Medicine
DOI 10.3390/jcm11133916PMC PMC9267383
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Abstract

This study aimed to evaluate the clinical utility of the subclinical hypothyroidism (SCH) marker, elevated thyroid-stimulating hormone (TSH) and thyroid antibodies in their ability to predict subsequent gestational diabetes mellitus (GDM). In a prospective clinical trial, 230 pregnant women were screened for thyroid function during the first trimester of pregnancy. Increased TSH levels with normal free thyroxine (fT4) were considered SCH. The titers of thyroid peroxidase antibody (anti TPO Ab) at >35 IU/mL and thyroglobulin antibody (anti Tg Ab) at >115 IU/mL were considered as antibodies present. According to the OGTT results, the number of pregnant women with GDM showed the expected growth trend, which was 19%. Two groups of pregnant women were compared, one with GDM and the other without. Increased TSH levels and the presence of thyroid antibodies showed a positive correlation with the risk of GDM. TSH levels were significantly higher in pregnant women with GDM, p = 0.027. In this study, 25.6% of pregnant women met the diagnostic criteria for autoimmune thyroiditis. Hashimoto’s thyroiditis was significantly more common in GDM patients, p < 0.001. Through multivariate logistic regression, it was demonstrated that patient age, TSH 4 IU/mL, and anti TPO Ab > 35 IU/mL are significant predictors of gestational diabetes mellitus that may improve first-trimester pregnancy screening performance, AUC: 0.711; 95% CI: 0.629–0.793.

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  • In Serbia, ADA or IADPSG criteria for GDM diagnosis are used; earlier, 100 g OGTT was used in high-risk patients.

    “In Serbia the ADA or IADPSG criteria for GDM diagnosis are used [189,190,191]. Earlier, the 100 g OGTT was used in high-risk patients [189].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [191]

    Materials and Methods §2.2 (page unavailable) says this Serbian study diagnosed GDM using IADPSG/WHO criteria with a 75 g OGTT. It does not establish that ADA criteria are used in Serbia or say that high-risk patients previously received a 100 g OGTT. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In Serbia, Milovanovic et al. presented a lower GDM incidence of 19.5%.

    “A lower GDM incidence (19.5%) was presented by Milovanovic et al. in their study assessing usefulness of thyroid screening in GDM prediction [191].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [191]

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Metadata

Authors
Milovanović, Z., Filimonović, D., Soldatović, I., & Karadžov Orlić, N.
Affiliations
  • University of Belgrade (RS)
  • Clinic for Gynaecology and Obstetrics Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
Corresponding author
Milovanović, Zagorka
ORCID
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2022-07-05
Volume
11
Issue
13
Pages
3916
ISSN
2077-0383 (ISSN-L)
DOI
10.3390/jcm11133916
PMC
PMC9267383
OpenAlex
W4284708683
Cited by
10
References
3
Citations by year
2026: 1 · 2025: 5 · 2024: 1 · 2023: 2 · 2022: 1
FWCI
2.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Keywords
gestational diabetes mellitus, subclinical hypothyroidism, thyroid screening, first trimester, thyroid-stimulating hormone, thyroid peroxidase antibodies, thyroglobulin antibodies, Hashimoto's thyroiditis, autoimmune thyroiditis, risk prediction, pregnancy screening

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