Gestational hypothyroidism: development of mild hypothyroidism in early pregnancy in previously euthyroid women.

Abstract:

OBJECTIVE:To determine the proportion of euthyroid women attending a fertility practice who develop hypothyroidism in very early pregnancy (gestational hypothyroidism [GHT]), and to examine the association of GHT with exogenous gonadotropin treatment. DESIGN:Retrospective cohort study. SETTING:A private reproductive medicine practice. PATIENT(S):All healthy women (N = 94) with infertility or recurrent pregnancy loss, TSH level <2.5 mIU/L, negative thyroid peroxidase antibodies at initial evaluation, and not taking thyroid medication, who conceived during an 18-month period. INTERVENTION(S):Usual fertility care; 30 women who had received exogenous gonadotropins. MAIN OUTCOME MEASURE(S):Serum TSH level at the time of pregnancy detection. RESULT(S):Gestational hypothyroidism (TSH ≥ 2.5 mIU/L) developed in 23 of 94 women (24%). The mean increase in serum TSH level from initial evaluation to early pregnancy was 0.45 ± 0.08 [SE] mIU/L. There was a trend toward the association of GHT with use of exogenous gonadotropins. Gestational hypothyroidism was positively associated with initial prepregnancy TSH level. CONCLUSION(S):Euthyroid women may develop mild hypothyroidism in early pregnancy, especially after exogenous gonadotropin treatment. Appropriate vigilance will allow for timely levothyroxine treatment.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Hammond KR,Cataldo NA,Hubbard JA,Malizia BA,Steinkampf MP

doi

10.1016/j.fertnstert.2015.03.006

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

1532-6.e1

issue

6

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(15)00205-8

journal_volume

103

pub_type

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