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Pregnancy hypothyroidism incidence and complications using the 2011 and 2017 ATA cutoff values. Experience at a maternity hospital in a densely populated area in Mexico City

  • Rodrigo Ayala-Yáñez ORCID logo EMAIL logo , Andres Villapando-Basaldúa , Alejandra Halffter-Mijares , Dan Morgenstern-Kaplan , Ixel Lorena Ruíz-Cabrera and Guadalupe Herrera-Fernández
Published/Copyright: May 10, 2022
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 50 Issue 8

Abstract

Objectives

Normal thyroid activity has an essential role in fetal development, its deficiency may hamper fetal neurodevelopment and neonatal growth. The quantitation of thyroid hormones although useful, still exposes differences on cut off levels to diagnose thyroid deficit accurately that can elicit under or over diagnosis of thyroid dysfuntion.

Methods

A total of 839 pregnant patients were studied for thyroidal clinical assessment through quantitation of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) circulating levels. Patients evaluated for prenatal and neonatal outcomes. Thyroid function deficiencies were determined with the American Thyroid Association (ATA) 2011 and 2017 values. Statistical analysis searched for associations between variables, odds ratios (OR) and correlations were calculated to evaluate the reliability of the cutoff values recommended by the ATA.

Results

Mean age of our cases was 27.5 + 5.83 years at diagnosis, mean gestational age at first consultation was 23.8 + 10.5 weeks. Mean TSH levels detected were: 2.5 + 1.89 mIU/L, total T3: 3.55 + 4.1 ng/dL, FT4: 3.14 + 4.4 ng/dL. The ATA 2011 values yielded 332 hypothyroidism cases vs. 507 euthyroid patients, a total incidence of 39.6% vs. the ATA 2017 values, diagnosing 100 hypothyroidism cases and 739 euthyroid patients, total incidence of 11.9%. Association with complications were not significant.

Conclusions

Using ATA 2017 values showed a decreased population with gestational hypothyroidism, hence preventing overdiagnosis and over-treatment. No significant complications were associated, requiring the determination of new regional values. Education and sensibilization of our population is needed to comply with early prenatal consultation and thyroid function testing.

Keywords: gestational hypothyroidism; hypothyroidism; pregnancy; thyroxine; TSH cutoff values; TSH values
Corresponding author: Rodrigo Ayala-Yáñez, Department of Obstetrics and Gynecology, ABC Medical Center, Mexico City, Mexico; Ob/Gyn, Centro Médico ABC, Mexico City, Mexico; Universidad Anáhuac México – Campus Norte, Huixquilucan, Mexico; and Asociación Hispano Mexicana I.A.P., Mexico City, Mexico, E-mail:

  1. Research funding: None declared.

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

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Received: 2021-10-11
Accepted: 2022-04-03
Published Online: 2022-05-10
Published in Print: 2022-10-26

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. WAPM Guideline
  3. Ultrasound in labor: clinical practice guideline and recommendation by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine Foundation
  4. Original Articles – Obstetrics
  5. Racial and ethnic distribution of US randomized controlled trials in obstetrics: a retrospective review
  6. Impact of earlier gestational diabetes screening for pregnant people with obesity on maternal and perinatal outcomes
  7. Variations in uterine closure technique: an institutional survey of obstetricians and implications for patient counseling and prevention of adverse sequelae
  8. Termination of pregnancy in the second trimester – the course of different therapy regimens
  9. Hyponatremia among preeclampsia patients – a potential sign of severity
  10. Effect of combined paracetamol and dexamethasone vs. paracetamol on postoperative nausea vomiting after cesarean section
  11. Lidocaine vs. tramadol vs. placebo wound infiltration for post-cesarean section pain relief: a randomized controlled trial
  12. Does the use of chitosan covered gauze for postpartum hemorrhage reduce the need for surgical therapy including hysterectomy? A databased historical cohort study
  13. The effect of advanced maternal age on perinatal outcomes in nulliparous pregnancies
  14. Evaluating the correlation between amniotic fluid volume and estimated fetal weight in healthy pregnant women
  15. Metabolic characterization of amniotic fluid of fetuses with isolated choroid plexus cyst
  16. Does a cervical pessary reduce the rate of preterm birth in women with a short cervix?
  17. Research progress on N6-methyladenosine in the human placenta
  18. Why are women deciding against birth in alongside midwifery units? A prospective single-center study from Germany
  19. Pregnancy hypothyroidism incidence and complications using the 2011 and 2017 ATA cutoff values. Experience at a maternity hospital in a densely populated area in Mexico City
  20. Expression pattern and clinical significance of microRNA-let-7a and IFN-gamma in placental tissue of patients with preeclampsia with severe features
  21. Original Articles – Fetus
  22. Management of neonates with 35 weeks of gestational age or more with infectious risk factors at birth: opportunities for improvement
https://doi.org/10.1515/jpm-2021-0522
Keywords for this article
gestational hypothyroidism; hypothyroidism; pregnancy; thyroxine; TSH cutoff values; TSH values

Articles in the same Issue

  1. Frontmatter
  2. WAPM Guideline
  3. Ultrasound in labor: clinical practice guideline and recommendation by the WAPM-World Association of Perinatal Medicine and the PMF-Perinatal Medicine Foundation
  4. Original Articles – Obstetrics
  5. Racial and ethnic distribution of US randomized controlled trials in obstetrics: a retrospective review
  6. Impact of earlier gestational diabetes screening for pregnant people with obesity on maternal and perinatal outcomes
  7. Variations in uterine closure technique: an institutional survey of obstetricians and implications for patient counseling and prevention of adverse sequelae
  8. Termination of pregnancy in the second trimester – the course of different therapy regimens
  9. Hyponatremia among preeclampsia patients – a potential sign of severity
  10. Effect of combined paracetamol and dexamethasone vs. paracetamol on postoperative nausea vomiting after cesarean section
  11. Lidocaine vs. tramadol vs. placebo wound infiltration for post-cesarean section pain relief: a randomized controlled trial
  12. Does the use of chitosan covered gauze for postpartum hemorrhage reduce the need for surgical therapy including hysterectomy? A databased historical cohort study
  13. The effect of advanced maternal age on perinatal outcomes in nulliparous pregnancies
  14. Evaluating the correlation between amniotic fluid volume and estimated fetal weight in healthy pregnant women
  15. Metabolic characterization of amniotic fluid of fetuses with isolated choroid plexus cyst
  16. Does a cervical pessary reduce the rate of preterm birth in women with a short cervix?
  17. Research progress on N6-methyladenosine in the human placenta
  18. Why are women deciding against birth in alongside midwifery units? A prospective single-center study from Germany
  19. Pregnancy hypothyroidism incidence and complications using the 2011 and 2017 ATA cutoff values. Experience at a maternity hospital in a densely populated area in Mexico City
  20. Expression pattern and clinical significance of microRNA-let-7a and IFN-gamma in placental tissue of patients with preeclampsia with severe features
  21. Original Articles – Fetus
  22. Management of neonates with 35 weeks of gestational age or more with infectious risk factors at birth: opportunities for improvement
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