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Association of Maternal Thyroid Function with Gestational Hypercholanemia.

Xi Yang1,2,3, Chen Zhang1,2,3, Catherine Williamson4

  • 1The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Thyroid : Official Journal of the American Thyroid Association
|December 23, 2021
PubMed
Summary
This summary is machine-generated.

High free thyroxine (fT4) in pregnancy is linked to elevated bile acid levels and increased risk of gestational hypercholanemia. Thyroid hormone levels, particularly fT4, play a crucial role in bile acid metabolism during pregnancy.

Keywords:
hypercholanemiaintrahepatic cholestasis of pregnancypregnancythyroid hormonetotal bile acid

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Area of Science:

  • Endocrinology
  • Perinatal Medicine
  • Hepatology

Background:

  • Elevated bile acid concentration is linked to adverse perinatal outcomes.
  • Thyroid hormone is known to regulate bile acid metabolism.
  • Clinical data on thyroid function and bile acid metabolism in pregnant women is limited.

Purpose of the Study:

  • To investigate the association between thyroid function and bile acid concentrations.
  • To explore the risk of gestational hypercholanemia in relation to thyroid function.

Main Methods:

  • Prospective cohort study of 68,016 singleton pregnancies.
  • Routine screening of thyroid function (TSH, fT4) and total bile acid (TBA).
  • Analysis using multiple linear and logistic regression models.

Main Results:

  • Higher free thyroxine (fT4) in early or late pregnancy correlated with increased TBA and hypercholanemia risk.
  • Overt and subclinical hyperthyroidism in late pregnancy significantly increased hypercholanemia risk.
  • Thyroid-stimulating hormone (TSH) showed complex associations with TBA, but not consistently with hypercholanemia.

Conclusions:

  • Elevated fT4 during pregnancy is a significant risk factor for gestational hypercholanemia.
  • Hyperthyroidism in pregnancy may represent a novel risk factor for hypercholanemia.
  • Thyroid function, specifically fT4 levels, influences bile acid concentrations during pregnancy.