Do elevated thyrotropin levels increase the risk of miscarriages: yes or no?

Area of Science:

• Endocrinology
• Reproductive Medicine
• Obstetrics

Background:

• Thyroid dysfunction is a growing concern in pregnancy.
• Elevated thyrotropin (TSH) levels may be associated with adverse pregnancy outcomes.
• Investigating the correlation between TSH and miscarriage frequency is crucial for maternal health.

Purpose of the Study:

• To examine the correlation between elevated thyrotropin (TSH) levels and the frequency of miscarriages.
• To assess the prevalence of subclinical hypothyroidism in women with a history of miscarriage.
• To identify risk factors influencing miscarriage, including TSH levels and body mass index (BMI).

Main Methods:

• A cross-sectional study involving 380 pregnant women.
• Measurement of TSH, anti-TPO antibodies, and FT4 in women who experienced miscarriage (N=179) and those with normal pregnancies (N=201).
• Logistic multivariate regression analysis to determine the influence of TSH and BMI on miscarriage risk.

Main Results:

• The incidence of subclinical hypothyroidism was significantly higher in the miscarriage group (61.4%) compared to the control group (15.79%).
• Mean TSH levels were significantly higher in the miscarriage group (4.31 ± 2.55 mIU/L) versus the control group (1.95 ± 0.86 mIU/L).
• Elevated TSH (OR 1.47) and BMI (OR 1.14) were significant predictors of miscarriage. The combination of thyroid autoimmunity and TSH > 2.5 mIU/L increased miscarriage risk to 65.75%.

Conclusions:

• Higher TSH levels in early pregnancy are associated with obesity and may indicate maternal thyroid dysfunction.
• Maintaining optimal thyroid function during the first trimester is vital for positive perinatal outcomes.
• Early detection and management of thyroid dysfunction in pregnancy are essential to reduce miscarriage rates.