The effects of screening and intervention of subclinical hypothyroidism on pregnancy outcomes: a prospective multicenter single-blind, randomized, controlled study of thyroid function screening test during pregnancy

Purpose: To evaluate the effect of subclinical hypothyroidism (SCH) screening and intervention on pregnancy outcomes and explore the significance of thyroid function during early pregnancy. Methods: Pregnant women were recruited from Peking Union Medical College Hospital (screening group for measuri...

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Published in:The journal of maternal-fetal & neonatal medicine 2016-05, Vol.29 (9), p.1391-1394
Main Authors: Ma, Liangkun, Qi, Hong, Chai, Xiaofeng, Jiang, Fang, Mao, Su, Liu, Juntao, Zhang, Shaoqin, Lian, Xiaolan, Sun, Xiujing, Wang, Danhua, Ren, Jie, Yan, Qi
Format: Article
Language:English
Subjects:
Adult
Female
Humans
Hypothyroidism - blood
Hypothyroidism - diagnosis
Mass Screening - statistics & numerical data
Pregnancy
Pregnancy Complications - blood
Pregnancy Complications - diagnosis
Pregnancy Outcome
subclinical hypothyroidism
thyroid function tests
Thyrotropin - blood
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Summary:Purpose: To evaluate the effect of subclinical hypothyroidism (SCH) screening and intervention on pregnancy outcomes and explore the significance of thyroid function during early pregnancy. Methods: Pregnant women were recruited from Peking Union Medical College Hospital (screening group for measuring thyroid function and thyroid antibody in early pregnancy) and Haidian Maternal & Child Health Hospital (control group whose serum was stored and measured shortly after delivery) from July 2011 to December 2012. Thyrotropin levels 2.5-10 mIU/L and free T4 levels in normal range were considered SCH. Some of the screening group were treated with levothyroxine and adjusted. The others did not take medicine but kept a regular follow-up visit to doctors after antenatal clinic. The pregnancy outcomes and complications were compared. Results: 1671 women (675 in screening group and 996 in control group) were recruited. 419 (167 from screening group) women was diagnosed as SCH. In screening group, 105 SCH and 4 hypothyroid women received thyroid hormone replacement therapy. The miscarriage and fetal macrosomia risks were lower, and cesarean was higher in screening group than control. Conclusion: Screening and intervention of SCH can significantly reduce the incidence rate of miscarriage.
ISSN:1476-7058
1476-4954
DOI:10.3109/14767058.2015.1049150