Preconception TSH and pregnancy outcomes: a population-based cohort study in 184 611 women.

Abstract:

BACKGROUND:Whether subclinical hypothyroidism adversely impacts pregnancy outcomes is inconclusive, and limited data are available on the optimal TSH range in women planning pregnancy. OBJECTIVE:To investigate the association between maternal preconception TSH levels and pregnancy outcomes. DESIGN:Population-based cohort study. METHODS:From 2010 to 2012, the free National Pre-pregnancy Checkups Project recruited 248 501 pairs of volunteer couples across China, of which 184 611 women, who subsequently became pregnant, were studied. Maternal TSH was measured within 6 months prior to conception. Participants were grouped according to TSH: 0·48-2·49 mIU/l (n = 133 232, 72%), 2·50-4·28 mIU/l (n = 44 239, 24%) and 4·29-10·0 mIU/l (n = 7140, 4%). Multivariable logistic regression models were used to study the association between TSH and pregnancy outcomes. MAIN OUTCOMES:Pregnancy loss, gestational age (GA), delivery modes and birthweight. RESULTS:The overall incidence of adverse pregnancy outcomes was 28·6%. Compared with TSH 0·48-2·50 mIU/l, TSH 2·50-4·29 mIU/l was associated with spontaneous abortion [aOR: 1·10, 95% confidence interval (CI): 1·03-1·18], preterm birth (aOR: 1·09, 95% CI: 1·04-1·15) and operative vaginal delivery (aOR: 1·15, 95% CI: 1·09-1·21), while TSH 4·29-10 mIU/l was correlated with spontaneous abortion (aOR: 1·15, 95% CI: 1·10-1·22), stillbirth (aOR: 1·58, 95% CI: 1·10-2·28), preterm birth (aOR: 1·20, 95% CI: 1·08-1·34), caesarean section (aOR: 1·15, 95% CI: 1·10-1·22) and large for gestational age (LGA) infants (aOR: 1·12, 95% CI: 1·04-1·21). CONCLUSION:Preconception TSH elevation was associated with increased risk of adverse pregnancy outcomes, even within the normal nonpregnant range.

journal_name

Clin Endocrinol (Oxf)

journal_title

Clinical endocrinology

authors

Chen S,Zhou X,Zhu H,Yang H,Gong F,Wang L,Zhang M,Jiang Y,Yan C,Li J,Wang Q,Zhang S,Pan H

doi

10.1111/cen.13329

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

816-824

issue

6

eissn

0300-0664

issn

1365-2265

journal_volume

86

pub_type

杂志文章
  • Quantitative growth hormone secretion and final adult height.

    abstract:OBJECTIVE:The relationship of quantitative GH secretion to height, growth velocity and puberty is complex and has been the subject of extensive study in children. This study was designed to relate quantitative GH secretion to final height. SUBJECTS:Twenty tall (> 183 cm, 90th centile for adult height) and 20 short (< ...

    journal_title:Clinical endocrinology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2265.1999.00844.x

    authors: Trainer PJ,Palermo M,Kirk JM,Fanciulli G,Perry LH,Delitala G,Besser GM

    更新日期:1999-11-01 00:00:00

  • Testosterone administration increases adrenal response to adrenocorticotrophin.

    abstract:OBJECTIVE:Various studies have demonstrated coexistence of ovarian and adrenal hyperandrogenism in women. This study was designed to determine whether testosterone can increase the response of the adrenal gland to stimulation by adrenocorticotrophin (ACTH). DESIGN:Non-randomized intervention in a university teaching h...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1994.tb03010.x

    authors: Polderman KH,Gooren LJ,van der Veen EA

    更新日期:1994-05-01 00:00:00

  • Cystic fibrosis and normal fibroblasts have identical glucocorticoid receptor profiles and induced protein responses.

    abstract::The possibility of differences in glucocorticoid sensitivity between normal and cystic fibrosis fibroblasts was studied in cultured cells derived from forearm skin biopsies. Both normal and cystic fibrosis cells bound tritiated dexamethasone with high affinity (Kd 37 degrees C approximately equal to 10 nmol/1) to a li...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1983.tb00586.x

    authors: Khalid BA,Gyorki S,Warne GL,Funder JW

    更新日期:1983-04-01 00:00:00

  • Measurement of free thyroxine and free triiodothyronine in asymptomatic subjects with high concentrations of serum TSH and a history of radioiodine therapy.

    abstract::Total and free thyroid hormones were measured in a group of asymptomatic subjects with high circulating TSH concentrations and a previous history of radioiodine therapy. Subjects in the high TSH group all fell within the normal range for measurements of total T4, total T3 and T4/TBG ratio. Concentrations of free T4 or...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1984.tb00100.x

    authors: Franklyn JA,Sheppard MC,Ramsden DB,Hoffenberg R

    更新日期:1984-05-01 00:00:00

  • Investigation of delayed puberty.

    abstract::Delayed puberty is defined arbitrarily on the basis of statistical consideration, when no signs of puberty have occurred at 2.0 SD (13.4 years in girls and 13.8 in boys) above the mean chronological age for the onset of puberty. The vast majority of these patients have no endocrine abnormality and their pubertal devel...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1995.tb01899.x

    authors: Albanese A,Stanhope R

    更新日期:1995-07-01 00:00:00

  • Is postablation whole-body 131 I scintigraphy still necessary in intermediate-risk papillary thyroid cancer patients with pre-ablation stimulated thyroglobulin

    abstract:OBJECTIVE:Postablation whole-body scintigraphy, which is performed 5-7 days after administration of ablation activity of radioactive iodine-131 (131 I) in patients with thyroid cancer, is considered a routine procedure for remnant ablation and a useful tool for disease staging. However, the relationship of pre-ablation...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/cen.13158

    authors: Liu B,Chen Y,Jiang L,He Y,Huang R,Kuang A

    更新日期:2017-01-01 00:00:00

  • Effect of mifepristone on folliculogenesis in women treated with recombinant FSH.

    abstract:OBJECTIVE:To study the mechanism through which mifepristone interrupts folliculogenesis. DESIGN:Normally ovulating women undergoing donor intrauterine insemination (IUI) treatment were investigated during two menstrual cycles treated with gonadotrophins. In the first cycle (FSH cycle), the women were given 150 IU reco...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2265.1997.1290951.x

    authors: Messinis IE,Krishnan M,Kazem R,Khadilkar S,Templeton AA

    更新日期:1997-03-01 00:00:00

  • Grey-scale analysis allows a quantitative evaluation of thyroid echogenicity in the patients with Hashimoto's thyroiditis.

    abstract:OBJECTIVE:In the present study we have performed a grey-scale quantitative analysis of thyroid echogenicity in the patients affected by Hashimoto's thyroiditis (HT), obtaining a numerical estimate of the degree of hypoechogenicity associated with the appearance of thyroid dysfunction. MATERIALS AND METHODS:The study g...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2265.2003.01829.x

    authors: Mazziotti G,Sorvillo F,Iorio S,Carbone A,Romeo A,Piscopo M,Capuano S,Capuano E,Amato G,Carella C

    更新日期:2003-08-01 00:00:00

  • Monitoring serum insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), IGF-I/IGFBP-3 molar ratio and leptin during growth hormone treatment for disordered growth.

    abstract:OBJECTIVE:Serum IGF-I levels are monitored during GH replacement treatment in adults with GH deficiency (GHD) to guide GH dose adjustment and to minimize occurrence of GH-related side-effects. This is not routine practice in children treated with GH. The aim of this study was to evaluate changes in (1) serum IGF-I, IGF...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2265.2000.01105.x

    authors: Tillmann V,Patel L,Gill MS,Whatmore AJ,Price DA,Kibirige MS,Wales JK,Clayton PE

    更新日期:2000-09-01 00:00:00

  • The effect of oral glucose on the leucocyte sodium pump in normal and obese subjects.

    abstract::The effect of oral glucose (40 g/m2 body surface area) on the leucocyte 22Na efflux rate constants (ERC) was studied in 13 normal weight and 10 obese subjects. The ouabain-sensitive 22Na ERC was higher in leucocytes isolated from fasting obese subjects (median [range] for obese 2.77 [2.33-3.11] vs normals 1.91 [1.57-2...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1987.tb01161.x

    authors: Ng LL,Hockaday TD

    更新日期:1987-09-01 00:00:00

  • Effects of evening vs morning thyroxine ingestion on serum thyroid hormone profiles in hypothyroid patients.

    abstract:OBJECTIVE:Standard drug information resources recommend that l-thyroxine be taken half an hour before breakfast on an empty stomach, to prevent interference of its intestinal uptake by food or medication. We observed cases in which TSH levels improved markedly after changing the administration time of l-thyroxine to th...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.2006.02681.x

    authors: Bolk N,Visser TJ,Kalsbeek A,van Domburg RT,Berghout A

    更新日期:2007-01-01 00:00:00

  • Diagnostic performance of HMGA2 gene expression for differentiation of malignant thyroid nodules: A systematic review and meta-analysis.

    abstract:OBJECTIVE:The purpose of the current study was to investigate the diagnostic performance of high mobility group A2 (HMGA2) gene expression for differentiation of malignant thyroid nodules through a systematic review and meta-analysis. DESIGN:The MEDLINE/PubMed and EMBASE database, from the earliest available date of i...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章,meta分析

    doi:10.1111/cen.13853

    authors: Kim BH,Kim SJ,Kim M,Lee SW,Jeong SY,Pak K,Kim K,Kim IJ

    更新日期:2018-12-01 00:00:00

  • Relationship between leptin levels and bone mineral density in the elderly.

    abstract:OBJECTIVE:To assess the relationship between circulating leptin levels, bone mineral content and density in the elderly. DESIGN:A cross-sectional study. PATIENTS:A cohort of 92 men and 171 women, with ages ranging from 68 to 75 years, selected as a healthy and normal functioning group, in the city centre of Verona. ...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2265.2003.01808.x

    authors: Zoico E,Zamboni M,Adami S,Vettor R,Mazzali G,Tosoni P,Bissoli L,Bosello O

    更新日期:2003-07-01 00:00:00

  • Abnormal pubertal development in primary hypothyroidism.

    abstract::We have studied three patients (1M, 2F), age range 10.9 to 15.5 years, who had abnormal sexual maturation secondary to primary hypothyroidism. The boy had inappropriately large testes for his stage of puberty, the girls had isolated breast development and there was absence of pubertal growth acceleration. FSH, LH, TSH...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1988.tb03682.x

    authors: Pringle PJ,Stanhope R,Hindmarsh P,Brook CG

    更新日期:1988-05-01 00:00:00

  • Effects of growth hormone release-inhibiting hormone and bromocryptine (CB 154) in states of abnormal pituitary-adrenal function.

    abstract::Growth hormone release-inhibiting hormone (GHR-IH) was administered to five patients with abnormal pituitary-adrenal function. There was immediate suppression by about 50% of ACTH levels in two patients who had undergone bilateral adrenalectomy because of Cushing's disease; one of them had Nelson's syndrome. Bromocryp...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1976.tb02831.x

    authors: Benker G,Hackenberg K,Hamburger B,Reinwein D

    更新日期:1976-03-01 00:00:00

  • Responses to the 35% CO challenge in postpartum women.

    abstract::Lactation has been associated with suppression of some components of the neuroendocrine stress response. In humans, suppression of the hypothalamo-pituitary-adrenal (HPA) axis has been demonstrated in response to both a psychological and an exercise challenge, but appears to be limited to a short period of time follow...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.2004.02133.x

    authors: Kaye J,Soothill P,Hunt M,Lightman S

    更新日期:2004-11-01 00:00:00

  • Evaluation of an inexpensive calcium absorption index in healthy older men and women.

    abstract:OBJECTIVE:Calcium absorption is an important determinant of calcium retention and bone metabolism. However, most methods of measuring calcium absorption, including the well-established dual stable isotope method, are costly and cumbersome to implement. We evaluated whether an oral calcium tolerance test (OCTT), which i...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2265.2009.03576.x

    authors: Ceglia L,Abrams SA,Harris SS,Rasmussen HM,Dallal GE,Dawson-Hughes B

    更新日期:2010-01-01 00:00:00

  • Peroxisome proliferator-activated receptor gamma agonism modifies the effects of growth hormone on lipolysis and insulin sensitivity.

    abstract:CONTEXT:Peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonists such as thiazolidinediones (TZDs) improve insulin sensitivity in type 2 diabetes mellitus (T2DM) through effects on fat metabolism whereas GH stimulates lipolysis and induces insulin resistance. OBJECTIVE:To evaluate the impact of TZDs on f...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1365-2265.2008.03231.x

    authors: Krag MB,Nielsen S,Guo Z,Pedersen SB,Schmitz O,Christiansen JS,Jørgensen JO

    更新日期:2008-09-01 00:00:00

  • Cushing's disease due to female gonadotroph adenoma of the pituitary.

    abstract::A 39-year-old woman presented with amenorrhoea, hyperprolactinaemia and sellar mass. Bromocriptine normalized PRL levels but failed to suppress tumour growth. Subsequently, she developed clinical signs and elevated blood cortisol levels consistent with a diagnosis of Cushing's disease. A pituitary tumour was removed w...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1995.tb02047.x

    authors: Ikeda H,Yoshimoto T,Kovacs K,Horvath E

    更新日期:1995-09-01 00:00:00

  • Homozygosity of the d3-growth hormone receptor polymorphism is associated with a high total effect of GH on growth and a low BMI in girls with Turner syndrome.

    abstract:OBJECTIVE:The protein polymorphism of the GH receptor caused by genomic deletion of exon 3 (d3) has been linked to the magnitude of the first-year-growth response to GH in girls with Turner syndrome. Here, we studied the long-term effect of GH therapy in Turner syndrome in correlation to this polymorphism. DESIGN:The ...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.2007.03090.x

    authors: Binder G,Trebar B,Baur F,Schweizer R,Ranke MB

    更新日期:2008-04-01 00:00:00

  • Comparison of the diagnostic accuracy of combined elastosonography and BRAF analysis vs cytology and ultrasonography for thyroid nodule suspected of malignancy.

    abstract:OBJECTIVE:Diagnosing thyroid nodules preoperatively using traditional diagnostic tools - ultrasonography (US) and cytology - still carries a considerable degree of uncertainty, and surgery is recommended for a far from negligible number of patients simply for diagnostic purposes. Thyroid elastosonography (USE) and BRAF...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.2012.04427.x

    authors: Nacamulli D,Nico L,Barollo S,Zambonin L,Pennelli G,Girelli ME,Casal Ide E,Pelizzo MR,Vianello F,Negro I,Watutantrige-Fernando S,Mantero F,Rugge M,Mian C

    更新日期:2012-10-01 00:00:00

  • A CTLA-4 gene polymorphism is associated with both Graves disease and autoimmune hypothyroidism.

    abstract:OBJECTIVE:The autoimmune thyroid diseases, Graves disease and autoimmune hypothyroidism, result from a complex interaction between genetic, environmental and endogenous factors. The genetic loci conferring susceptibility remain unclear. A recent report has demonstrated an association between a microsatellite polymorphi...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2265.1997.1710996.x

    authors: Kotsa K,Watson PF,Weetman AP

    更新日期:1997-05-01 00:00:00

  • Growth hormone secreting pituitary carcinoma: a case report and literature review.

    abstract::Only five cases of growth hormone secreting pituitary carcinoma have been documented. We present a 49-year-old West Indian male with grossly elevated plasma growth hormone (760-10,400 mU/l), and a large aggressive pituitary tumour that continued to grow despite repeated pituitary surgery, radiotherapy and medical ther...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2265.1992.tb02306.x

    authors: Stewart PM,Carey MP,Graham CT,Wright AD,London DR

    更新日期:1992-08-01 00:00:00

  • Vitamin A and iron supplementation is as efficient as hormonal therapy in constitutionally delayed children.

    abstract:OBJECTIVE:To assess the effect of nutritional supplementation on growth and puberty in constitutionally delayed children. PATIENTS:One hundred and two boys, 13.6-15.5 years of age, who were referred because of short stature and delayed puberty. METHODS:The boys were randomly allocated to one of the following treatmen...

    journal_title:Clinical endocrinology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2265.2004.02034.x

    authors: Zadik Z,Sinai T,Zung A,Reifen R

    更新日期:2004-06-01 00:00:00

  • A comparison between the effects of SMS 201-995, bromocriptine and a combination of both drugs on hormone release by the cultured pituitary tumour cells of acromegalic patients.

    abstract::The in-vivo reaction of the plasma GH concentration to the administration of the somatostatin analogue SMS 201-995, bromocriptine and their combination were compared with the in-vitro effects of both compounds and their combination on GH release and the GH tumour cell content of 9 acromegalic patients. Exposure of cul...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1987.tb00834.x

    authors: Lamberts SW,Verleun T,Hofland L,Del Pozo E

    更新日期:1987-07-01 00:00:00

  • Radiation and neuroregulatory control of growth hormone secretion.

    abstract:OBJECTIVE:Cranial irradiation frequently results in growth hormone (GH) deficiency. Patients with radiation-induced GH deficiency usually remain responsive to exogenous growth hormone releasing hormone, implying radiation damages the hypothalamus rather than the pituitary. Little is known about the effect of cranial ir...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1994.tb02525.x

    authors: Ogilvy-Stuart AL,Wallace WH,Shalet SM

    更新日期:1994-08-01 00:00:00

  • Withdrawal of endogenous sympathetic drive lowers blood pressure in primary aldosteronism.

    abstract::We were able to observe the effect of withdrawal of endogenous sympathetic drive in a hypertensive patient with an aldosterone-secreting adrenal adenoma. Acute stimulation of both carotid sinus nerves lowered blood pressure to normotensive or hypotensive levels by reducing peripheral resistance. When chronic carotid s...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.1981.tb00663.x

    authors: Nicholls MG,Julius S,Zweifler AJ

    更新日期:1981-09-01 00:00:00

  • Incidence of abnormal liver biochemical tests in hyperthyroidism.

    abstract:OBJECTIVE:Abnormal serum liver function tests are common in patients with untreated thyrotoxicosis, even prior to the initiation of antithyroidal medications that may worsen the severity of the abnormal serum liver biochemistries. There is a wide range of the incidence of these abnormalities in the published literature...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/cen.13312

    authors: Lin TY,Shekar AO,Li N,Yeh MW,Saab S,Wilson M,Leung AM

    更新日期:2017-05-01 00:00:00

  • BRAF mutations in an Italian cohort of thyroid cancers.

    abstract:OBJECTIVE:Recently, a somatic point mutation of the BRAF gene (V599E) has been identified as the most common genetic event in papillary thyroid carcinoma (PTC) with a variable frequency (about 25-70%) in different series from USA, Japan, Portugal and Ukraine. DESIGN:In the present study, the genetic analysis of BRAF i...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.2004.02089.x

    authors: Fugazzola L,Mannavola D,Cirello V,Vannucchi G,Muzza M,Vicentini L,Beck-Peccoz P

    更新日期:2004-08-01 00:00:00

  • Seladin-1/DHCR24 expression in normal ovary, ovarian epithelial and granulosa tumours.

    abstract:OBJECTIVE:The human DIMINUTO/DWARF1 homolog seladin-1/DHCR24 has been recently reported to be up-regulated in adrenocortical adenomas. Seladin-1 expression has been reported in the normal ovary. Granulosa cell tumours of the ovary (GCT) as with adrenocortical adenomas arise from a steroidogenic tissue, respond to pitui...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章

    doi:10.1111/j.1365-2265.2005.02308.x

    authors: Fuller PJ,Alexiadis M,Jobling T,McNeilage J

    更新日期:2005-07-01 00:00:00