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Gestation specific reference intervals for thyroid function tests in pregnancy

  • Süleyman Akarsu , Filiz Akbiyik , Eda Karaismailoglu and Zeliha Gunnur Dikmen EMAIL logo
Published/Copyright: January 9, 2016
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 8

Abstract

Background: Thyroid function tests are frequently assessed during pregnancy to evaluate thyroid dysfunction or to monitor pre-existing thyroid disease. However, using non-pregnant reference intervals can lead to misclassification. International guidelines recommended that institutions should calculate their own pregnancy-specific reference intervals for free thyroxine (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH). The objective of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function tests in pregnant Turkish women and to compare these with the age-matched non-pregnant women.

Methods: Serum samples were collected from 220 non-pregnant women (age: 18–48), and 2460 pregnant women (age: 18–45) with 945 (39%) in the first trimester, 1120 (45%) in the second trimester, and 395 (16%) in the third trimester. TSH, FT4 and FT3 were measured using the Abbott Architect i2000SR analyzer.

Results: GRIs of TSH, FT4 and FT3 for first trimester pregnancies were 0.49–2.33 mIU/L, 10.30–18.11 pmol/L and 3.80–5.81 pmol/L, respectively. GRIs for second trimester pregnancies were 0.51–3.44 mIU/L, 10.30–18.15 pmol/L and 3.69–5.90 pmol/L. GRIs for third trimester pregnancies were 0.58–4.31 mIU/L, 10.30–17.89 pmol/L and 3.67–5.81 pmol/L. GRIs for TSH, FT4 and FT3 were different from non-pregnant normal reference intervals.

Conclusions: TSH levels showed an increasing trend from the first trimester to the third trimester, whereas both FT4 and FT3 levels were uniform throughout gestation. GRIs may help in the diagnosis and appropriate management of thyroid dysfunction during pregnancy which will prevent both maternal and fetal complications.

Keywords: pregnancy; thyroid function tests
Corresponding author: Zeliha Gunnur Dikmen, Clinical Pathology Laboratory, Faculty of Medicine, Department of Medical Biochemistry, Hacettepe University, Ankara 06100, Turkey, Phone: +903123052841, Fax: +903123100580, E-mail:

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) 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.

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Received: 2015-6-16
Accepted: 2015-11-30
Published Online: 2016-1-9
Published in Print: 2016-8-1

©2016 by De Gruyter

Articles in the same Issue

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  2. Editorials
  3. Laboratory analytical quality – the process continues
  4. Measurement uncertainty – a revised understanding of its calculation and use
  5. Review
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  7. Opinion Papers
  8. Is the combination of trueness and precision in one expression meaningful? On the use of total error and uncertainty in clinical chemistry
  9. The problem with total error models in establishing performance specifications and a simple remedy
  10. Measurement uncertainty for clinical laboratories – a revision of the concept
  11. Uncertainty in measurement and total error – are they so incompatible?
  12. General Clinical Chemistry and Laboratory Medicine
  13. Using the hazard ratio to evaluate allowable total error in predictive measurands
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  16. Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China
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  18. Patient-performed extraction of faecal calprotectin
  19. Comparison of the clinical utility of the Elia CTD Screen to indirect immunofluorescence on Hep-2 cells
  20. Reference Values and Biological Variations
  21. Sex-related differences in the association of ghrelin levels with obesity in adolescents
  22. Gestation specific reference intervals for thyroid function tests in pregnancy
  23. Cancer Diagnostics
  24. SOX17 promoter methylation in plasma circulating tumor DNA of patients with non-small cell lung cancer
  25. Dopamine concentration in blood platelets is elevated in patients with head and neck paragangliomas
  26. Letters to the Editor
  27. Cancer dynamics and the success of cancer screening programs
  28. Mother’s instinct – a rare case of multiple test interferences due to heterophile antibodies
  29. Sigma metric or defects per million opportunities (DPMO): the performance of clinical laboratories should be evaluated by the Sigma metrics at decimal level with DPMOs
  30. A national survey of preanalytical handling of oral glucose tolerance tests in pregnancy
  31. Updating pregnancy diabetes guidelines: is (y)our laboratory ready?
  32. Low serum bilirubin values are associated with pulmonary embolism in a case-control study
  33. Effect of Hb H on HbA1c measurements as measured by IFCC reference method and affinity HPLC
  34. Adipocytes in venipunctures cause falsely elevated S-100B serum values
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  36. Theranos phenomenon – part 4: Theranos at an International Conference
https://doi.org/10.1515/cclm-2015-0569
Keywords for this article
pregnancy; thyroid function tests

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Laboratory analytical quality – the process continues
  4. Measurement uncertainty – a revised understanding of its calculation and use
  5. Review
  6. Substrate-zymography: a still worthwhile method for gelatinases analysis in biological samples
  7. Opinion Papers
  8. Is the combination of trueness and precision in one expression meaningful? On the use of total error and uncertainty in clinical chemistry
  9. The problem with total error models in establishing performance specifications and a simple remedy
  10. Measurement uncertainty for clinical laboratories – a revision of the concept
  11. Uncertainty in measurement and total error – are they so incompatible?
  12. General Clinical Chemistry and Laboratory Medicine
  13. Using the hazard ratio to evaluate allowable total error in predictive measurands
  14. Performance of electrolyte measurements assessed by a trueness verification program
  15. Analytical interference by monoclonal immunoglobulins on the direct bilirubin AU Beckman Coulter assay: the benefit of unsuspected diagnosis from spurious results
  16. Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China
  17. Analytical and clinical evaluation of the new Fujirebio Lumipulse®G non-competitive assay for 25(OH)-vitamin D and three immunoassays for 25(OH)D in healthy subjects, osteoporotic patients, third trimester pregnant women, healthy African subjects, hemodialyzed and intensive care patients
  18. Patient-performed extraction of faecal calprotectin
  19. Comparison of the clinical utility of the Elia CTD Screen to indirect immunofluorescence on Hep-2 cells
  20. Reference Values and Biological Variations
  21. Sex-related differences in the association of ghrelin levels with obesity in adolescents
  22. Gestation specific reference intervals for thyroid function tests in pregnancy
  23. Cancer Diagnostics
  24. SOX17 promoter methylation in plasma circulating tumor DNA of patients with non-small cell lung cancer
  25. Dopamine concentration in blood platelets is elevated in patients with head and neck paragangliomas
  26. Letters to the Editor
  27. Cancer dynamics and the success of cancer screening programs
  28. Mother’s instinct – a rare case of multiple test interferences due to heterophile antibodies
  29. Sigma metric or defects per million opportunities (DPMO): the performance of clinical laboratories should be evaluated by the Sigma metrics at decimal level with DPMOs
  30. A national survey of preanalytical handling of oral glucose tolerance tests in pregnancy
  31. Updating pregnancy diabetes guidelines: is (y)our laboratory ready?
  32. Low serum bilirubin values are associated with pulmonary embolism in a case-control study
  33. Effect of Hb H on HbA1c measurements as measured by IFCC reference method and affinity HPLC
  34. Adipocytes in venipunctures cause falsely elevated S-100B serum values
  35. Earlier detection of sepsis by Candida parapsilosis using three-dimensional cytographic anomalies on the Mindray BC-6800 hematological analyzer
  36. Theranos phenomenon – part 4: Theranos at an International Conference
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