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Observational Study
. 2016 Dec;85(6):942-948.
doi: 10.1111/cen.13127. Epub 2016 Jun 29.

Early pregnancy thyroid hormone reference ranges in Chilean women: the influence of body mass index

Lorena Mosso  1 , Alejandra Martínez  1 , María Paulina Rojas  2 , Gonzalo Latorre  3 , Paula Margozzini  3 , Trinidad Lyng  1 , Jorge Carvajal  4 , Claudia Campusano  1 , Eugenio Arteaga  1 , Laura Boucai  5
Affiliations
Observational Study

Early pregnancy thyroid hormone reference ranges in Chilean women: the influence of body mass index

Lorena Mosso et al. Clin Endocrinol (Oxf). 2016 Dec.

Abstract

Objective: Thyroid dysfunction and obesity during pregnancy have been associated with negative neonatal and obstetric outcomes. Thyroid hormone reference ranges have not been established for the pregnant Hispanic population. This study defines thyroid hormone reference ranges during early pregnancy in Chilean women and evaluates associations of body mass index (BMI) with thyroid function.

Design, patients, measurements: This is a prospective observational study of 720 healthy Chilean women attending their first prenatal consultation at an outpatient clinic. Thyroid function [TSH, Free T4, Total T4 and antithyroid peroxidase antibodies (TPOAb)] and BMI were assessed at 8·8 ± 2·4 weeks of gestational age.

Results: Median, 2·5th percentile (p2·5), and 97·5th percentile (p97·5) TSH values were higher, while median, p2·5, and p97·5 free T4 values were lower in obese patients compared with normal weight patients. Obesity was associated with a median TSH 16% higher (P = 0·035) and a median free T4 6·5% lower (P < 0·01) than values from patients with normal weight. BMI had a small, but statistically significant effect on TSH (P = 0·04) and free T4 (P < 0·01) when adjusted by maternal age, TPO antibodies, parity, sex of the newborn, gestational age and smoking. In all TPOAb (-) patients, median (p2·5-p.97·5) TSH was 1·96 mIU/l (0·11-5·96 mIU/l) and median (p2·5-p.97·5) free T4 was 14·54 pmol/l (11·1 - 19·02 pmol/l). Applying these reference limits, we found a prevalence of overt and subclinical hypothyroidism of 0·9% and 3·05% respectively.

Conclusions: TSH distributes at higher values and free T4 at lower values in obese pregnant women compared to normal weight pregnant women. Thyroid hormone reference ranges derived from Chilean patients with negative TPOAb are different from the fixed internationally proposed reference ranges and may be used in the Hispanic population.

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Conflict of interest statement

Disclosure Statement: No competing financial interests exist.

Figures

Figure 1
Figure 1
Median TSH, and Free T4 according to BMI categories in all patients (n=720). Ordinates of panel A are TSH values in mIU/L and ordinates in panel B are Free T4 values in pmol/L.
Figure 2
Figure 2
Distribution of serum TSH values within the normal reference interval (2.5th– 97.5th percentiles) in the first trimester in 502 Chilean women with negative TPO antibodies.
See this image and copyright information in PMC

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