Correlation between Thyroid Stimulating Hormone (TSH) levels in maternal blood and risk of spontaneous abortion in the first trimester

Baldzieva, Sanja and Jovevska, Svetlana (2023) Correlation between Thyroid Stimulating Hormone (TSH) levels in maternal blood and risk of spontaneous abortion in the first trimester. Knowledge - International Journal, 60 (4). pp. 579-586.

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Abstract

Thyroid dysfunction is common among women between the ages of 20 and 45, and thus a more common
etiology for spontaneous abortion in the first trimester of pregnancy. The prevalence of thyroid disorders in this
group of patients is between 5 and 7% for subclinical hypothyroidism, 2-4.5% for hypothyroidism, 0.5-1% for
hyperthyroidism and 5-10% for autoimmune thyroiditis/thyroid autoimmunity. Every normal pregnancy is followed
by changes in the physiology of the thyroid gland, which are also reflected by changes in the thyroid function tests.
Physiological adaptation is necessary so that the pregnant woman's body can respond to the increased metabolic
needs during pregnancy. Diseases of the thyroid gland reduce its ability to adapt and respond to the new needs of
pregnancy and this can result in a poor pregnancy outcome and, in most cases, spontaneous abortion.
Objective: The objective of this paper is to determine the relationship between the level of thyroid stimulating
hormone (TSH) in the first trimester of pregnancy and the occurrence of spontaneous abortion.
Methods: Serum thyroid-stimulating hormone (TSH), free and total thyroxine (fT4 and tT4) and antithyroid
peroxidase antibodies (antiTPO Ab) were determined in 52 pregnant women in the first trimester of pregnancy.
Women were divided into groups according to the level of TSH and the presence of antiTPO Ab, according to the
latest recommendations of the American Thyroid Association (ATA) and according to the local reference values for
TSH. The risk of spontaneous abortion in the first trimester was calculated for each group as well as the correlation
with other parameters: age of the patients, week of occurrence of spontaneous abortion, history of previous
spontaneous abortions and number of pregnancies.
Results: Spontaneous abortion in the first trimester of pregnancy was detected in 38.5% (n=20) of the examined
cases. Using the Chi-Square test, a cut-off value of 2.00 mIU/L for TSH levels was found to be a significant value in
relation to the number of spontaneous abortions (p=0.005). Patients with spontaneous abortion in the first trimester
with TSH value > 2.0 mIU/L were 65% of all. Patients with positive antiTPO-Ab were 22%, and in 16% of the
patients with spontaneous abortion antiTPO-Ab were with a value above the upper reference value.
Conclusion: In our study, results suggest a redefinition of the upper limit of reference values of TSH in the first
trimester of pregnancy in addition to its reduction. History of previous abortion and age over 30 years were found to
be significant predictive factors.
Keywords: thyroid stimulating hormone (TSH), spontaneous abortion, thyroid dysfunction.

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Svetlana Jovevska
Date Deposited:	07 Dec 2023 10:13
Last Modified:	07 Dec 2023 10:13
URI:	https://eprints.ugd.edu.mk/id/eprint/32803

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