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Related Experiment Video

Updated: Jan 28, 2026

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Thyroid function reference ranges during pregnancy in a large Chinese population and comparison with current

Xi Yang1, Yu Meng, Yong Zhang

  • 1Department of Gynecology and Obstetrics, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.

Chinese Medical Journal
|February 27, 2019
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Summary

Establishing thyroid function reference ranges for pregnant Chinese women is crucial for accurate diagnosis. This study provides population-specific ranges, aligning with ATA guidelines and improving diagnostic accuracy in China.

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Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Clinical Chemistry

Background:

  • Accurate thyroid function reference ranges are vital for diagnosing thyroid disease in pregnancy.
  • There is no global consensus on applying the American Thyroid Association (ATA) guidelines to Chinese populations.
  • This study addresses the need for population-specific thyroid function reference ranges in pregnant Chinese women.

Purpose of the Study:

  • To establish thyroid function reference ranges for pregnant Chinese women.
  • To evaluate the suitability of current ATA guidelines for the Chinese population.
  • To compare diagnostic accuracy using local versus ATA-defined reference ranges.

Main Methods:

  • A large cohort of 52,027 pregnant women was studied from 2013-2016.
  • Thyroid stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibody (TPOAb) levels were measured in the first and third trimesters.
  • Reference ranges were derived from TPOAb-negative women; comparisons were made using Mann-Whitney U tests.

Main Results:

  • Established TSH reference ranges: 0.03-3.52 mIU/L (1st trimester) and 0.39-3.67 mIU/L (3rd trimester).
  • Established FT4 reference ranges: 11.7-19.7 pmol/L (1st trimester) and 9.1-14.4 pmol/L (3rd trimester).
  • Using 2011 ATA criteria could lead to overdiagnosis (7.0% and 4.0%); using 2017 ATA criteria could lead to missed diagnoses (1.2% and 0.8%) compared to local ranges.

Conclusions:

  • Population-based thyroid function reference ranges are recommended for diagnosing thyroid disease in pregnant women in China.
  • The established ranges align with current ATA guidelines.
  • These local reference ranges can be adopted in Eastern China if identical assays are used, especially when population-specific ranges are unavailable.