Publication:
High First Trimester Levels of TSH as an Independent Risk Factor for Gestational Diabetes Mellitus: A Retrospective Cohort Study.

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Date

2022-06-27

Authors

Fernandez Alba, Juan Jesus
Castillo Lara, Maria
Jimenez Heras, Jose Manuel
Moreno Cortes, Rocio
Gonzalez Macias, Carmen
Vilar Sanchez, Angel
San Laureano, Florentino Carral
Moreno Corral, Luis Javier

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MDPI
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Abstract

Although numerous articles have found an association between alterations in thyroid function and the risk of gestational diabetes mellitus (GDM), other studies have failed to demonstrate this association. This may be due to the different cut-off points used to define subclinical hypothyroidism. We aim to clarify the role of thyroid stimulating hormone (TSH) level in GDM within pregnant women with normal free thyroxine (fT4) levels. This retrospective cohort study was performed in 6775 pregnant women. The association between TSH and GDM was assessed by bivariate and multivariate logistic regression. Pregnant women with subclinical hypothyroidism are at significantly greater risk for GDM when compared with euthyroid pregnant women (OR = 1.85; 95% CI = 1.36-2.52). We have also observed that TSH levels increase the risk of GDM within euthyroid pregnant women, since the TSH levels between 2.5 and 4.71 showed a higher risk of GDM than those whose TSH levels are between 0.31 and 2.49 (OR = 1.54; 95% CI = 1.28-1.84). In addition, pregnant women with positive thyroid antibodies have almost 2.5 times the risk of developing GDM (OR = 2.47; 95% CI = 1.57-3.89). Our results support that in pregnant women with normal fT4 levels, higher first trimester TSH level implies a higher risk of GDM.

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MeSH Terms

Pregnancy
Diabetes, Gestational
Thyroxine
Pregnancy Trimester, First
Pregnant Women
Logistic Models

DeCS Terms

Diabetes gestacional
Embarazo
Modelos logísticos
Mujeres embarazadas
Primer trimestre del embarazo
Tiroxina

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Keywords

Gestational diabetes mellitus, Subclinical hyperthyroidism, Subclinical hypothyroidism, Thyroid antibodies, Thyroid stimulating hormone, Thyrotropin

Citation

Fernández Alba JJ, Castillo Lara M, Jiménez Heras JM, Moreno Cortés R, González Macías C, Vilar Sánchez Á, et al. High First Trimester Levels of TSH as an Independent Risk Factor for Gestational Diabetes Mellitus: A Retrospective Cohort Study. J Clin Med. 2022 Jun 29;11(13):3776