Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy

During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for...

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Bibliographic Details
Published in:Journal of Korean medical science 2015, 30(9), 204, pp.1308-1312
Main Authors: Kim, Hye Sung, Kim, Byoung Jae, Oh, Sohee, Lee, Da Young, Hwang, Kyu Ri, Jeon, Hye Won, Lee, Seung Mi
Format: Article
Language:English
Subjects:
Adult
Algorithms
Biomarkers - blood
Diagnosis, Computer-Assisted - methods
Diagnostic Techniques, Obstetrical and Gynecological
Female
Gestational Age
Humans
Hypothyroidism - blood
Hypothyroidism - diagnosis
Original
Pregnancy
Pregnancy Complications - blood
Pregnancy Complications - diagnosis
Reproducibility of Results
Republic of Korea
Sensitivity and Specificity
Thyrotropin - blood
의학일반
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Summary:During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, P
ISSN:1011-8934
1598-6357
DOI:10.3346/jkms.2015.30.9.1308