Diagnosis, treatment, and management of gestational hypothyroidism. The TIROGEST study

There is no agreement on the procedures to be used for diagnosis and treatment of gestational thyroid dysfunction. Controversy still exists on the normal range of thyroid-stimulating hormone (TSH) levels and use of gestational hypothyroidism (GH) screening. The aim of this study was to assess diagno...

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Published in:Endocrinología, diabetes y nutrición. diabetes y nutrición., 2020-01, Vol.67 (1), p.36-42
Main Authors: Donnay, Sergio, Fajardo, Carmen, Fernández-García, José Carlos, Torres, Teresa, Bandrés, Orosia, Domínguez, José Ramón, Menéndez, Edelmiro, Serrano, Joaquín, Torrejón, Sara, López, Irela, Pineda, José Javier, Muñoz, José, Lucas, Anna, Tortosa, Frederic, Moll, Gracia, Vich, Francisca
Format: Article
Language:English
Subjects:
Diagnosis
Diagnóstico
España
Gestational hypothyroidism
Hipotiroidismo gestacional
Management
Manejo
Spain
Tratamiento
Treatment
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Summary:There is no agreement on the procedures to be used for diagnosis and treatment of gestational thyroid dysfunction. Controversy still exists on the normal range of thyroid-stimulating hormone (TSH) levels and use of gestational hypothyroidism (GH) screening. The aim of this study was to assess diagnosis and treatment of thyroid dysfunction during pregnancy in a group of Spanish hospitals. This was a retrospective, multicenter study in pregnant females with GH attending Spanish healthcare centers from March 2013 to July 2014. Variables analyzed included diagnosis criteria for GH (availability of universal screening for gestational thyroid disorders and TSH reference values (RVs) by trimester of pregnancy): risk factors for GH, iodine intake from food or supplementation, gestational age (at diagnosis/treatment) and l-thyroxine treatment. Fourteen centers participated in the study. Universal screening was performed in only half of the centers, and only 14% had their own TSH RVs. Overall, 257 pregnant women were enrolled, 53.7% with hypothyroidism (HT) diagnosed before pregnancy (pre-GH) and 46.3% with HT diagnosed during pregnancy (intra-GH). A comparison of intra-GH and pre-GH women showed that intra-GH women made their first visit later (59.7% vs. 75.4% respectively before week 12, p=0.007) and had more frequently high TSH levels (>2.5μIU/ml) during the first trimester (94.4% vs. 67.0% respectively, p
ISSN:2530-0180
2530-0180
DOI:10.1016/j.endien.2020.01.002