Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019, 163(3):265-268

The prevalence of maternal hypothyroidism in first trimester screening from 11 to 14 weeks of gestation

Tomas Saleka,b, Ishraq Dhaifalahb,c,d, Dagmar Langovae, Jana Havalovac
a Department of Clinical Biochemistry and Pharmacology, Tomas Bata Hospital in Zlin a. s., Havlickovo nabrezi 600, 76275 Zlin, Czech Republic
b Department of Biomedical Sciences, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava - Zabreh, Czech Republic
c Department of Obstetrics and Gynecology, Tomas Bata Hospital in Zlin a. s., Havlickovo nabrezi 600, 76275 Zlin, Czech Republic
d FETMED (Fetmed Fetal Medicine Center and Genetics), Olomouc and Ostrava, Czech Republic
e Internal Medicine Clinic, Tomas Bata Hospital in Zlin a. s., Havlickovo nabrezi 600, 76275 Zlin, Czech Republic

Aim: The aim of this study was to determine the prevalence of maternal hypothyroidism in the first trimester from 11 to 14 weeks of gestation according to the American Thyroid Association (ATA) guidelines from 2017 and to compare the rates for singleton and twin pregnancies.

Methods: A total of 4965 consecutive Caucasian singleton pregnancies and 109 Caucasian twin pregnancies were included in the investigation. Patients with a history of thyroid gland disorder were excluded. Subclinical maternal hypothyroidism was defined as a thyroid stimulating hormone (TSH) concentration above the 97.5th percentile and free thyroxine (fT4) within the range of a reference population of women at 11-14 weeks of gestation. Overt maternal hypothyroidism was defined as a TSH concentration above the 97.5th percentile and an fT4 below the 2.5th percentile of the reference population.TSH, fT4, and anti thyroid peroxidase antibody (TPOAb) were measured by immunochemiluminescent assays on an 16200 Abbott Architect analyzer.

Results: The prevalence of hypothyroidism for twin pregnancies was no higher than that for singleton pregnancies; 6.42% (7/109) vs. 5.32% (264/4965), respectively; P=0.61. All twin pregnancies were subclinical. Singleton hypothyroid pregnancies included 4.91% (244 cases) of subclinical and 0.41% (20 cases) of overt hypothyroidism. The prevalence of TPOAb positive hypothyroid women for twin pregnancies and singleton pregnancies was 71% (5/7) vs. 52% (137/264 cases), respectively but the differences were not statistically significant; P=0.31.

Conclusion: Each first trimester screening center should establish its TSH and fT4 reference ranges. Our center had higher upper reference limits of TSH than that of the universally fixed limit of 2.5 mU/L, which led to a lower measured prevalence of maternal hypothyroidism. A large number of hypothyroid women were TPOAb positive.

Keywords: hypothyroidism, pregnancy, thyroid disease, immunoassay, gestation

Received: June 2, 2018; Revised: September 19, 2018; Accepted: October 2, 2018; Prepublished online: November 6, 2018; Published: September 23, 2019  Show citation

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Salek, T., Dhaifalah, I., Langova, D., & Havalova, J. (2019). The prevalence of maternal hypothyroidism in first trimester screening from 11 to 14 weeks of gestation. Biomedical papers, 163(3), 265-268
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