RT Journal Article
T1 Hypothyroidism screening during first trimester of pregnancy
A1 Castillo Lara, Maria
A1 Vilar Sanchez, Angel
A1 Canavate Solano, Consuelo
A1 Soto Pazos, Estefania
A1 Iglesias Alvarez, Maria
A1 Gonzalez Macias, Carmen
A1 Ayala Ortega, Carmen
A1 Moreno Corral, Luis Javier
A1 Fernandez Alba, Juan Jesus
K1 Hypothyroidism
K1 Pregnancy trimester
K1 first
K1 Thyrotropin
K1 Maternal serum screening tests
K1 Pregnancy complications
K1 diagnosis
K1 Thyroid function tests
K1 Subsequent neuropsychological development
K1 American thyroid association
K1 Subclinical hypothyroidism
K1 Autoimmunity
K1 Management
K1 Diagnosis
K1 Women
K1 Abnormalities
K1 Dysfunction
K1 Guidelines
AB Background: Subclinical hypothyroidism is defined as an elevated thyroid-stimulating hormone level with a normal thyroxin level without signs or symptoms of hypothyroidism. Although it is well accepted that overt hypothyroidism has a deleterious impact on pregnancy, recent studies indicate that subclinical hypothyroidism may affect maternal and fetal health. Studies suggest an association between miscarriage and preterm delivery in euthyroid women positive for anti-peroxidase antibodies and/or anti-thyroglobulin antibodies. A proposal of a new set-point to diagnose SCH was recently published. The aim of this research was to determine the optimal thyroid-stimulating hormone cut-off point to screen for subclinical hypothyroidism in the first trimester of gestation in a population of our clinical area and to determine the diagnostic value of this screening test for detecting anti-thyroid peroxidase antibodies.Methods: This cross-sectional study determines the cutoff point for SCH screening and evaluates its usefulness to detect TPO Ab using the Receiver Operating Characteristics (ROC) curve. Prevalence of SCH was calculated using as cut-off 2.5 mIU/L, 4 mIU/L, and our TSH 97.5th percentile. The ability to detect positive anti-thyroglobulin antibodies (TG Ab) and anti-thyroid peroxidase antibodies (TPO Ab) in patients with levels of TSH > 97.5th percentile was determined by ROC curves.Results: The mean, range and standard deviation of TSH was 2.15 +/- 1.34 mIU/L (range 0.03-8.82); FT4 was 1.18 +/- 0.13 ng/dL (range 0.94-1.3); TG Ab was 89.87 +/- 413.56 IU/mL (range 0.10-4000); and TPO Ab was 21.61 +/- 46.27 IU/mL(range 0.10-412.4). The ROC. analysis of the ability of the TSH level to predict the presence of positive TPO Ab found an AUC of 0.563.Conclusion: In our population, the TSH cutoff value for gestational SCH screening is 4.7 mIU/L. Using the SEGO recommended 2.5 mIU/L TSH cut-off point, the prevalence of SCH is 37%. Applying the ATA 2017 recommended cutoff point of 4 mIU/L, the prevalence of SCH is 9.6%. Finally, when the cut-off of 4.7 mIU/L (our 97.5th centile) was used, the SCH prevalence is 5%. TSH levels in the first trimester of pregnancy are not useful to detect TPO Ab.
PB Bmc
SN 1471-2393
YR 2017
FD 2017-12-22
LK http://hdl.handle.net/10668/19122
UL http://hdl.handle.net/10668/19122
LA en
DS RISalud
RD Apr 19, 2025