Home Longitudinal evaluation of thyroid autoimmunity and function in pregnant Korean women
Article
Licensed
Unlicensed Requires Authentication

Longitudinal evaluation of thyroid autoimmunity and function in pregnant Korean women

  • Seong-Min Han , Jeong Hee Han , Jina A. Park , Frank A. Quinn , Joonseok Park and Eunsuk Oh EMAIL logo
Published/Copyright: August 27, 2013

Abstract

Background: Maternal thyroid dysfunction during pregnancy has been associated with adverse outcomes for both the mother and child. For this reason, it is important to understand thyroid status in pregnant women. However, there are relatively few published studies that examine thyroid function tests (TFT) and thyroid autoimmunity in non-Western pregnant women.

Methods: Serum samples were longitudinally collected throughout pregnancy from 108 Korean women. TFT, thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab) testing was performed. The impact of gestational age on TPO-Ab and Tg-Ab levels was evaluated and gestational age-specific reference intervals for TFT were established in antibody negative women.

Results: In the first trimester, TPO-Ab and Tg-Ab were positive in 13.9% and 16.7% of women, respectively. For antibody positive women, median autoantibody levels for TPO-Ab and Tg-Ab dropped from first trimester to near term (133.7–10.5 IU/mL, and 162.1–21.9 IU/mL, respectively). Antibody status influenced thyroid stimulating hormone (TSH) during the first trimester, and TSH, free T4 (FT4) and total T4 (TT4) in the early second trimester. Later in gestation, no significant differences in TFT were found based on antibody status. Gestational age-specific reference intervals for TFT were calculated in antibody negative women.

Conclusions: Laboratory evidence of autoimmune thyroid disease (AITD) is common in this population of pregnant Korean women. Antibody status influences TFT values in the first and early second trimester. Thyroid autoantibody status and titer change in an individual-specific manner throughout pregnancy. Gestational age-specific reference intervals should be utilized for interpretation of TFT results in pregnant women.


Corresponding author: Dr. Eunsuk Oh, Department of Internal Medicine, MizMedi Hospital, Seoul, Republic of Korea, E-mail:

The authors would like to thank the patients who participated in this study, and Dr. Haiyoung Jung for her review of the manuscript. Reagents to perform this study were supplied by Abbott Diagnostics.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Employment, stock ownership and supply of the reagents played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Research funding: None declared.

Employment or leadership: F. Quinn (Abbott Laboratories); J. Park (Hamni Medicare).

Honorarium: None declared.

Stock ownership: F. Quinn (Abbott Laboratories)

References

1. Negro R, Mestman JH. Thyroid disease in pregnancy. Best Pract Res Clin Endocrinol Metab 2011;25:927–43.10.1016/j.beem.2011.07.010Search in Google Scholar PubMed

2. Lazarus JH. Thyroid function in pregnancy. Br Med Bul 2010;97:137–48.10.1093/bmb/ldq039Search in Google Scholar PubMed

3. De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2012;7:2543–65.10.1210/jc.2011-2803Search in Google Scholar PubMed

4. Mandel SJ. Hypothyroidism and chronic autoimmune thyroiditis in the pregnant state: maternal aspects. Best Pract Res Clin Endocrinol Metab 2004;18:213–24.10.1016/j.beem.2004.03.006Search in Google Scholar PubMed

5. Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011;10:1081–125.10.1089/thy.2011.0087http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000295157800007&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed PubMed Central

6. Stricker R, Echenard M, Eberhart R, Chevailler MC, Perez V, Quinn FA, et al. Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals. Eur J Endocrinol 2007;157:509–14.10.1530/EJE-07-0249http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000250335600017&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

7. Wang Q, Yu B, Huang R, Cao F, Zhu Z, Sun D, et al. Assessment of thyroid function during pregnancy: the advantage of self-sequential longitudinal reference intervals. Arch Med Sci 2010;4:679–84.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000294988300022&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar

8. Clinical and Laboratory Standards Institute (CLSI). Defining, establishing, and verifying reference intervals in the clinical laboratory; approved guideline – 3rd ed. CLSI document C28-A3 (ISBN 1-56238-682-4). Wayne, PA: Clinical and Laboratory Standards Institute, 2008.Search in Google Scholar

9. La’ulu SL, Roberts WL. Ethnic differences in first-trimester thyroid reference intervals. Clin Chem 2011;57:913–5.10.1373/clinchem.2010.161240Search in Google Scholar PubMed

10. Teng X, Shan Z, Chen Y, Lai Y, Yu J, Shan L, et al. More than adequate iodine intake may increase subclinical hypothyroidism and autoimmune thyroiditis: a cross-sectional study based on two Chinese communities with different iodine intake levels. Eur J Endocrinol 2011;164:943–50.10.1530/EJE-10-1041Search in Google Scholar PubMed

11. Quinn FA, Armbruster DA. ARCHITECT family of analyzers. In: Wild D, editor. The immunoassay handbook, 4th ed. Theory and applications of ligand binding, ELISA and related techniques. Oxford: Elsevier, 2013:561–6.10.1016/B978-0-08-097037-0.00042-7Search in Google Scholar

12. La’ulu SL, Slev PR, Roberts WL. Performance characteristics of 5 automated thyroglobulin autoantibody and thyroid peroxidase autoantibody assays. Clin Chim Acta 2007;376:88–95.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000243585300015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f310.1016/j.cca.2006.07.018Search in Google Scholar PubMed

13. Owen WE, Gantzer ML, Lyons JM, Rockwood AL, Roberts WL. Functional sensitivity of seven automated thyroid stimulating hormone assays. Clin Chim Acta 2011;412:2336–9.10.1016/j.cca.2011.08.002http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000296686100055&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

14. Roberts RF, La’ulu SL, Roberts WL. Performance characteristics of seven automated thyroxine and T-uptake methods. Clin Chim Acta 2007;377:248–55.10.1016/j.cca.2006.10.008http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000243675000036&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

15. La’ulu SL, Roberts WL. Second-trimester reference intervals for thyroid function tests: the role of ethnicity. Clin Chem 2007;53:1658–64.10.1373/clinchem.2007.089680Search in Google Scholar PubMed

16. Medici M, de Rijke YB, Peeters RP, Visser W, de Muinck Keizer-Schrama SM, Jaddoe VV, et al. Maternal early pregnancy and newborn thyroid hormone parameters: the Generation R Study. J Clin Endocrinol Metab 2012;97:646–52.10.1210/jc.2011-2398Search in Google Scholar PubMed

17. Marwaha RK, Chopra S, Gopalakrishnan S, Sharma B, Kanawar, RS, Sastry A, et al. Establishment of reference range for thyroid hormones in normal pregnant Indian women. Br J Obstet Gynaecol 2008;115:602–6.10.1111/j.1471-0528.2008.01673.xSearch in Google Scholar PubMed

18. Orito Y, Oku H, Kubota S, Amino N, Shimogaki K, Hata M, et al. Thyroid function in early pregnancy in Japanese healthy women: relation to urinary iodine excretion, emesis, and fetal and child development. J Clin Endocrinol Metab 2009;94:1683–8.10.1210/jc.2008-2111http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000265851500032&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

19. Kim JY, Kim KR. Dietary iodine and urinary iodine excretion in patients with thyroid disease. Yonsei Medical J 2000;41:22–8.10.3349/ymj.2000.41.1.22Search in Google Scholar PubMed

20. Kim JY, Moon SJ, Kim KR, Sohn CY, Oh JJ. Dietary iodine intake and urinary iodine excretion in normal Korean Adults. Yonsei Medical J 1998;39:355–62.10.3349/ymj.1998.39.4.355Search in Google Scholar PubMed

21. Hwang S, Lee EY, Lee WK, Shin DY, Lee EJ. Correlation between iodine intake and thyroid function in subjects with normal thyroid function. Biol Trace Elem Res 2011;143:1393–7.10.1007/s12011-011-8997-xhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=000297348900018&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=b7bc2757938ac7a7a821505f8243d9f3Search in Google Scholar PubMed

22. Hoffman CS, Messer LC, Mendola P, Savitz DA, Herring AH, Hartmann KE. Comparison of gestational age at birth based on last menstrual period and ultrasound during the first trimester. Pediatr Perinat Epidemiol 2008;22:587–96.10.1111/j.1365-3016.2008.00965.xSearch in Google Scholar PubMed

Received: 2013-04-05
Accepted: 2013-07-29
Published Online: 2013-08-27
Published in Print: 2013-12-01

©2013 by Walter de Gruyter Berlin Boston

Articles in the same Issue

  1. Letters to the Editor
  2. The addition of MESNA in vitro prolongs prothrombin time similar to N-acetyl cysteine
  3. Detection of unknown β-thalassemia cases from atypical HbA1c chromatograms
  4. Analytical study of a new turbidimetric assay for urinary neutrophil gelatinase-associated lipocalin (NGAL) determination
  5. The rare bipolar-contracted red cell significance and correlation with red cell volume
  6. Howell-Jolly body interference in reticulocyte counts
  7. PBMC expressed adiponectin mRNA is predictive of survival in patients with gastric cancer
  8. Comparison study of two commercially available methods for the determination of infliximab, adalimumab, etanercept and anti-drug antibody levels
  9. Development and validation of a rapid and reliable high-performance liquid chromatography method for methadone quantification in human plasma and saliva
  10. Reply to Ruiz-Argüello et al.: Comparison study of two commercially available methods for the determination of infliximab, adalimumab, etanercept and anti-drug antibody levels
  11. Still more discussion on the journal impact factor
  12. The order of draw, myth or science
  13. Masthead
  14. Masthead
  15. Editorial
  16. Multidisciplinarity and interdisciplinarity at work: the prenatal diagnosis
  17. Research Articles
  18. Prenatal diagnosis of inherited diseases: 20 years’ experience of an Italian Regional Reference Centre
  19. Prenatal diagnosis of haemoglobinopathies: our experience of 523 cases
  20. Prenatal diagnosis of cystic fibrosis: an experience of 181 cases
  21. Prenatal diagnosis of haemophilia: our experience of 44 cases
  22. Prenatal molecular diagnosis of inherited neuromuscular diseases: Duchenne/Becker muscular dystrophy, myotonic dystrophy type 1 and spinal muscular atrophy
  23. Editorials
  24. Journal impact factor: the debate continues
  25. Estimation of uncertainty in measurements in the clinical laboratory
  26. Review
  27. Searching for genes involved in hypertension development in special populations: children and pre-eclamptic women. Where are we standing now?
  28. Opinion Paper
  29. More discussion on journal impact factor
  30. General Clinical Chemistry and Laboratory Medicine
  31. Category-specific uncertainty modeling in clinical laboratory measurement processes
  32. The order of draw: myth or science?
  33. Planned variation in preanalytical conditions to evaluate biospecimen stability in the National Children’s Study (NCS)
  34. Longitudinal evaluation of thyroid autoimmunity and function in pregnant Korean women
  35. Evaluation of the N Latex free light chain assay in the diagnosis and monitoring of AL amyloidosis
  36. Identification of an important potential confound in CSF AD studies: aliquot volume
  37. Cancer Diagnostics
  38. Double heterozygosity in the BRCA1 and BRCA2 genes in Italian family
  39. Quantification of EGFR autoantibodies in the amplification phenomenon of HER2 in breast cancer
  40. Diabetes
  41. SAA1 genetic polymorphisms are associated with plasma glucose concentration in non-diabetic subjects
  42. Acknowledgment
  43. Acknowledgment
Downloaded on 26.10.2025 from https://www.degruyterbrill.com/document/doi/10.1515/cclm-2013-0598/html
Scroll to top button