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Does foetal gender influence maternal thyroid parameters in pregnancy?

Georgiana Sitoris1, Flora Veltri1, Pierre Kleynen1

  • 1Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.

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Summary

Maternal thyroid function differs by fetal sex. Pregnant individuals with a male fetus have higher thyroid-stimulating hormone (TSH) levels and reference ranges in the first trimester compared to those with a female fetus.

Keywords:
foetalpregnancyreference rangesthyroid autoimmunitythyroid dysfunction

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Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Obstetrics

Background:

  • Maternal thyroid function is crucial during pregnancy.
  • The influence of fetal sex on maternal thyroid function remains largely unknown.
  • Establishing accurate first-trimester thyroid-stimulating hormone (TSH) reference ranges is essential for diagnosing thyroid disorders in pregnancy.

Purpose of the Study:

  • To investigate whether fetal sex influences maternal thyroid function during the first trimester of pregnancy.
  • To determine gender-specific TSH reference ranges in early pregnancy.
  • To assess the prevalence of thyroid disorders in relation to fetal sex.

Main Methods:

  • A cross-sectional study of 1663 pregnant women was conducted.
  • Serum TSH, free T4 (FT4), and thyroid peroxidase antibodies (TPOAb) were measured.
  • Exclusion criteria included multiple pregnancies, assisted pregnancies, and pre-existing thyroid treatment.

Main Results:

  • Women pregnant with a male fetus (MF) had significantly higher median TSH levels (1.24 mIU/L) compared to those with a female fetus (FF) (1.13 mIU/L) between 9-13 weeks gestation (P=0.021).
  • First-trimester TSH reference ranges were 0.03-3.89 mIU/L for FF and 0.03-3.53 mIU/L for MF.
  • The prevalence of subclinical hypothyroidism (SCH) and thyroid autoimmunity (TAI) did not significantly differ between groups.

Conclusions:

  • Pregnancies with a male fetus are associated with higher maternal TSH levels and an elevated upper limit for the first-trimester TSH reference range compared to pregnancies with a female fetus.
  • This difference may be linked to variations in human chorionic gonadotropin (hCG) levels, though not directly measured.
  • Further research is needed to determine the clinical significance of these fetal sex-related TSH variations.