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Abnormal thyroid function parameters in the second trimester of pregnancy are associated with breech presentation at
Rosa Vissenberg1, Tanja G M Vrijkotte2, Joris A M van der Post3
1Academic Medical Centre, Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands.
Summary
Elevated thyroid stimulating hormone (TSH) and low free thyroxine (FT4) in the second trimester of pregnancy are linked to a higher risk of breech presentation at term. Further research is needed for other trimesters.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Perinatal Medicine
Background:
- Thyroid dysfunction during pregnancy is a potential risk factor for abnormal fetal positioning.
- Breech presentation at term is a significant obstetric concern.
Purpose of the Study:
- To investigate the association between maternal thyroid function in early pregnancy and the occurrence of breech presentation at term.
Main Methods:
- Utilized data from the Amsterdam Born Children and their Development (ABCD) cohort, including 3347 pregnant women.
- Assessed thyroid function tests (TSH, FT4) in early pregnancy (median 12.9 weeks).
- Employed univariate and multivariate analyses to determine associations with term breech presentation.
Main Results:
- Increased thyroid stimulating hormone (TSH) in pregnancy was associated with a higher risk of breech presentation (aOR 2.32).
- Specifically, elevated TSH in the second trimester showed a strong association (aOR 3.7).
- Low second-trimester free thyroxine (FT4) was also linked to increased breech presentation risk (aOR 2.5).
Conclusions:
- Maternal TSH elevation and FT4 reduction in the second trimester are associated with an increased risk of term breech presentation.
- The relationship between abnormal thyroid function in the first or third trimesters and breech presentation remains uncertain.
