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The thyroid and pregnancy: a novel risk factor for very preterm delivery
Alex Stagnaro-Green1, Xinhua Chen, John D Bogden
1Department of Medicine, UMDNJ-New Jersey Medical School, Division of Endocrinology and Metabolism, 185 South Orange Avenue, Newark, NJ 17101-6035, USA. stagnaas@umdnj.edu
Summary
Maternal thyroid dysfunction, specifically high thyrotropin (TSH) levels and thyroglobulin antibodies, significantly increases the risk of very preterm delivery. This finding highlights the importance of thyroid health in pregnancy for preventing adverse neonatal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Neonatal Health
Background:
- Preterm delivery, particularly very preterm delivery (< 32 weeks), is a leading cause of neonatal mortality and morbidity.
- Maternal thyroid health is crucial during pregnancy, but its specific association with preterm birth requires further investigation.
Purpose of the Study:
- To investigate the association between maternal thyroid hormonal dysfunction and/or thyroid autoantibodies with the risk of preterm and very preterm delivery.
- To identify potential biomarkers for predicting preterm birth risk.
Main Methods:
- A prospective nested case-control study involving 953 pregnant women (gravidas).
- Maternal blood samples collected at entry to care were analyzed for thyroid stimulating hormone (TSH), thyroperoxidase antibody, and thyroglobulin antibody.
- Cases (n=124) were women with preterm delivery; controls (n=124) delivered at term.
Main Results:
- Maternal high thyrotropin (TSH) levels were associated with a greater than threefold increased risk of very preterm delivery.
- Positive thyroglobulin antibody status in early pregnancy was linked to a more than twofold increased risk of very preterm delivery.
- No significant association was found between TSH levels or thyroglobulin antibodies and moderately preterm delivery.
Conclusions:
- Maternal thyroid dysfunction, indicated by elevated TSH, is a significant risk factor for very preterm birth.
- Thyroid autoimmunity, specifically thyroglobulin antibodies, may also contribute to an increased risk of very preterm delivery.
- Monitoring maternal thyroid function in early pregnancy could aid in identifying and potentially mitigating the risk of very preterm birth.