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Related Concept Videos

Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Trimester-specific reference intervals for thyroid function parameters in pregnant Caucasian women using Roche

R M Dorizzi1, G Spiazzi2, N Rolli2

  • 1Clinical Pathology Unit, Hub Laboratory, AUSL Romagna, Cesena, Italy.

Journal of Endocrinological Investigation
|April 24, 2023
PubMed
Summary

Standard thyroid function tests are inaccurate during pregnancy. This study establishes trimester-specific reference intervals for thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) in pregnant Caucasian women, improving diagnostic accuracy.

Keywords:
FT3FT4PregnancyReference intervalTSHThyroid function

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Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Clinical Chemistry

Background:

  • Standard thyroid function reference intervals (RI) are inadequate for pregnancy, potentially leading to incorrect treatments and adverse pregnancy outcomes.
  • Accurate thyroid monitoring during gestation is crucial for maternal and fetal well-being.
  • Previous studies highlight the need for pregnancy-specific thyroid function RIs.

Purpose of the Study:

  • To establish trimester-specific reference intervals (RI) for thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) in healthy pregnant Caucasian women.
  • To provide updated reference limits for thyroid function tests used on Roche platforms during pregnancy.
  • To inform clinical practice regarding appropriate thyroid function assessment in pregnant individuals.

Main Methods:

  • Longitudinal collection of blood samples from 139 healthy Caucasian pregnant women across all trimesters.
  • Exclusion of participants with overt thyroid abnormalities (TSH > 10 mU/L) or positive TPO antibodies.
  • Analysis of TSH, FT4, and FT3 levels using Roche platforms to calculate trimester-specific reference intervals.

Main Results:

  • First-trimester TSH RI: 0.34-3.81 mU/L; second-trimester: 0.68-4.07 U/L; third-trimester: 0.63-4.00 mU/L.
  • FT4 and FT3 concentrations progressively decreased during pregnancy, with third-trimester medians 14.8% and 13.2% lower than in the first trimester, respectively.
  • Thyroid function parameters in the first trimester were comparable to post-partum measurements.

Conclusions:

  • This study provides crucial trimester-specific reference intervals for TSH, FT4, and FT3 in pregnant Caucasian women.
  • The findings support the adoption of these updated reference limits when utilizing Roche platforms for thyroid function testing during pregnancy.
  • Implementing these specific RIs can enhance diagnostic accuracy and optimize management of thyroid disorders in pregnancy.