Higher levels of thyrotropin in pregnancy and adverse pregnancy outcomes

Objective: To determine the frequency of subclinical hypothyroidism in women with pathological pregnancies and the association between elevated thyroid-stimulating hormone (TSH) and pregnancy outcome.Subjects and methods: A cross-sectional prospective study investigated value of TSH and free thyroxine (FT4) in (1) pregnant women with hypertension (HTA) (N=62) or preeclampsia (PE) (N=50), (2) women with gestational diabetes mellitus (GDM) (N=92) in pregnancy, and (3) women with normal pregnancies (control) (N=201). The level of statistical significance was set at p<.05.Results: Of the total 404 respondents, the highest incidence of subclinical hypothyroidism was in the group with preeclampsia 22%, followed HTA group 9.6%; GDM group 10.9% and in the control group 9% (p<.001). Higher levels of TSH were in the preeclampsia (2.51.54mIU/L) and in the HTA (2.03 +/- 0.97 mIU/L) compared with the control group (1.95 +/- 0.86mIU/L); (p<.001). Weight gain in pregnancy was significantly higher in women with TSH >3mIU/L (p=.003). There were no differences in the average TSH value between GDM (1.93 +/- 1.03mIU/L) and control group (p=.962).Conclusions: Early detection and optimal treatment of thyroid dysfunction before and in the first trimester of pregnancy reduces the risk of adverse pregnancy outcomes.