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Maturation of thyroid function in normal human foetuses.

M Ballabio1, U Nicolini, T Jowett

  • 1Department of Molecular Endocrinology, University College London, UK.

Clinical Endocrinology
|November 1, 1989
PubMed
Summary
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Fetal thyroid function matures significantly during gestation, with thyroid-stimulating hormone (TSH) levels remaining high. This indicates incomplete fetal thyroid gland responsiveness to TSH, impacting development.

Area of Science:

  • Endocrinology
  • Fetal Medicine
  • Reproductive Biology

Background:

  • Fetal thyroid hormone production is crucial for development.
  • Understanding fetal thyroid maturation is essential for diagnosing and managing congenital thyroid disorders.

Purpose of the Study:

  • To investigate the functional maturation of independent fetal thyroid activity.
  • To establish normal ranges for fetal thyroid parameters during gestation.

Main Methods:

  • Serum concentrations of total thyroxine (TT4), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and thyroxine-binding globulin (TBG) were measured.
  • Samples were collected from 23 fetuses aged 18-31 weeks via transabdominal cord insertion needling.

Main Results:

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  • TT4, FT4, TBG, and TSH levels significantly increased with gestational age.
  • FT4 and TBG reached adult ranges by 28 and 30 weeks, respectively; TT4 remained lower than adult levels.
  • TSH values were consistently higher than adult ranges, and the TSH/TT4 ratio decreased with gestation.

Conclusions:

  • Fetal thyroid gland shows incomplete responsiveness to TSH.
  • The fetal pituitary-thyroid feedback system operates at a different set point than in postnatal life.
  • Established normal ranges aid in antenatal diagnosis and treatment of fetal thyroid disorders.