Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study

Thyroid dysfunction is a frequently found endocrine disorder among reproductively aged women. Subclinical hypothyroidism is the most common condition of thyroid disorders during pregnancy and is defined as manifesting a thyro id-stimulating hormone concentration exceeding the trimester-specific refe...

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Main Authors: Jiashu Li, Aihua Liu, Haixia Liu, Chenyan Li, Weiwei Wang, Cheng Han, Xinyi Wang, Yuanyuan Zhang, Weiping Teng, Zhongyan Shan
Format: Article
Language:English
Published: Bioscientifica 2019-09-01
Series:Endocrine Connections
Subjects:
Online Access:https://ec.bioscientifica.com/view/journals/ec/8/9/EC-19-0316.xml
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record_format Article
collection DOAJ
language English
format Article
sources DOAJ
author Jiashu Li
Aihua Liu
Haixia Liu
Chenyan Li
Weiwei Wang
Cheng Han
Xinyi Wang
Yuanyuan Zhang
Weiping Teng
Zhongyan Shan
spellingShingle Jiashu Li
Aihua Liu
Haixia Liu
Chenyan Li
Weiwei Wang
Cheng Han
Xinyi Wang
Yuanyuan Zhang
Weiping Teng
Zhongyan Shan
Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study
Endocrine Connections
thyroid
reproduction
author_facet Jiashu Li
Aihua Liu
Haixia Liu
Chenyan Li
Weiwei Wang
Cheng Han
Xinyi Wang
Yuanyuan Zhang
Weiping Teng
Zhongyan Shan
author_sort Jiashu Li
title Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study
title_short Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study
title_full Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study
title_fullStr Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study
title_full_unstemmed Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study
title_sort maternal tsh levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study
publisher Bioscientifica
series Endocrine Connections
issn 2049-3614
2049-3614
publishDate 2019-09-01
description Thyroid dysfunction is a frequently found endocrine disorder among reproductively aged women. Subclinical hypothyroidism is the most common condition of thyroid disorders during pregnancy and is defined as manifesting a thyro id-stimulating hormone concentration exceeding the trimester-specific reference value, with a normal free thyroxine concentration. Here, we evaluated the prospective association between spontaneous miscarriage and first-trimester thyroid function. We conducted a case–control study (421 cases and 1684 controls) that was nested. Thyroid-st imulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) status were measured. We found that higher TSH was relat ed to spontaneous miscarriage (OR 1.21; 95% CI, 1.13–1.30, P < 0.001). Compared with women with TSH levels of 0.4–<2.5 mIU/L, the risk of miscarriage was increased in wom en with TSH levels of 2.5–<4.87 mIU/L (OR 1.47; 95% CI, 1.16–1.87) and TSH greater th an 4.87 mIU/L (OR 1.97; 95% CI, 1.22–3.18). After controlling for the confounding facto r, TPOAb positivity status and FT4, the results were similar. The present study showed that higher TSH was associated with miscarriage in early pregnancy. In fact, TSH levels betwee n 2.5 and 4.87 mIU/L increased the risk for miscarriage, with TSH greater than 4.87 mIU/L increasing the risk even further.
topic thyroid
reproduction
url https://ec.bioscientifica.com/view/journals/ec/8/9/EC-19-0316.xml
work_keys_str_mv AT jiashuli maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT aihualiu maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT haixialiu maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT chenyanli maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT weiweiwang maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT chenghan maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT xinyiwang maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT yuanyuanzhang maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT weipingteng maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
AT zhongyanshan maternaltshlevelsatfirsttrimesterandsubsequentspontaneousmiscarriageanestedcasecontrolstudy
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spelling doaj-f2876b77afd94716862142f70d6d75cb2020-11-25T02:05:23ZengBioscientificaEndocrine Connections2049-36142049-36142019-09-018912881293https://doi.org/10.1530/EC-19-0316Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control studyJiashu Li0Aihua Liu1Haixia Liu2Chenyan Li3Weiwei Wang4Cheng Han5Xinyi Wang6Yuanyuan Zhang7Weiping Teng8Zhongyan Shan9Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Endocrinology and Metabolism, The Second Hospital of Dalian Medical University, Dalian, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaDepartment of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang, Liaoning, ChinaThyroid dysfunction is a frequently found endocrine disorder among reproductively aged women. Subclinical hypothyroidism is the most common condition of thyroid disorders during pregnancy and is defined as manifesting a thyro id-stimulating hormone concentration exceeding the trimester-specific reference value, with a normal free thyroxine concentration. Here, we evaluated the prospective association between spontaneous miscarriage and first-trimester thyroid function. We conducted a case–control study (421 cases and 1684 controls) that was nested. Thyroid-st imulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) status were measured. We found that higher TSH was relat ed to spontaneous miscarriage (OR 1.21; 95% CI, 1.13–1.30, P < 0.001). Compared with women with TSH levels of 0.4–<2.5 mIU/L, the risk of miscarriage was increased in wom en with TSH levels of 2.5–<4.87 mIU/L (OR 1.47; 95% CI, 1.16–1.87) and TSH greater th an 4.87 mIU/L (OR 1.97; 95% CI, 1.22–3.18). After controlling for the confounding facto r, TPOAb positivity status and FT4, the results were similar. The present study showed that higher TSH was associated with miscarriage in early pregnancy. In fact, TSH levels betwee n 2.5 and 4.87 mIU/L increased the risk for miscarriage, with TSH greater than 4.87 mIU/L increasing the risk even further.https://ec.bioscientifica.com/view/journals/ec/8/9/EC-19-0316.xmlthyroidreproduction