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Thyroid function tests in pregnancy.

A Kumar1, N Gupta, T Nath

  • 1Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi. ashkumar@eth.net

Indian Journal of Medical Sciences
|September 27, 2003
PubMed
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Thyroid function tests, including serum tri-iodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH), change during pregnancy. This study established trimester-specific reference ranges for these hormones in healthy pregnant women.

Area of Science:

  • Endocrinology
  • Obstetrics
  • Reproductive Medicine

Background:

  • Thyroid function tests (TFTs) are crucial for maternal and fetal well-being during pregnancy.
  • Standard TFT values for non-pregnant women are not applicable during pregnancy and vary in iodine-deficient regions.
  • Establishing trimester-specific reference ranges for thyroid hormones is essential for accurate diagnosis and management.

Purpose of the Study:

  • To determine the normal ranges of serum tri-iodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) during the three trimesters of pregnancy.
  • To assess the trends of these thyroid hormone levels throughout gestation in healthy primigravidas.
  • To identify potential variations in thyroid hormone levels and their correlation with obstetric outcomes.

Main Methods:

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  • A prospective study included 124 apparently healthy, young primigravidas with no known metabolic disorders.
  • Serum T3, T4, and TSH levels were measured consecutively throughout the first, second, and third trimesters.
  • Participants underwent normal gestational carbohydrate intolerance testing.

Main Results:

  • Mean T3 levels increased from the first to the second trimester and then declined in the third.
  • Mean T4 levels showed a slight rise in the second trimester before decreasing in the third trimester.
  • Mean TSH levels progressively increased from the first to the third trimester. Three women (2.5%) had abnormal TSH with normal T3/T4 and good outcomes.

Conclusions:

  • This pilot study provides trimester-specific reference ranges for T3, T4, and TSH in healthy pregnant women.
  • The observed trends in thyroid hormone levels highlight the physiological adaptations during pregnancy.
  • Understanding these dynamic changes is vital for interpreting TFTs and ensuring optimal pregnancy care.