Sequential first- and second-trimester TSH, free thyroxine, and thyroid antibody measurements in women with known hypothyroidism

a FaSTER trial study

Monica R. McClain, Geralyn Lambert-Messerlian, James E. Haddow, Glenn E. Palomaki, Jacob A. Canick, Jane Cleary-Goldman, Fergal D. Malone, T. Flint Porter, David A. Nyberg, Peter S. Bernstein, Mary E. D'Alton

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: The purpose of this study was to examine how closely hypothyroidism management in the general pregnancy population satisfies recently issued guidelines and to determine whether improvements are indicated. Study Design: This was an observational study in which women at 5 recruitment centers in the first- and second-trimester evaluation of risk for aneuploidy trial allowed the use of sequentially obtained first- and second-trimester sera for additional research. Three hundred eighty-nine women had hypothyroidism by self-report. Thyroid-related measurements were performed on all samples between July 2004 and May 2005. Results: Forty-three percent of the thyroid-stimulating hormone (TSH) values are at or above recently recommended guidelines in the first trimester (2.5 mU/L), as opposed to 33% of the values in the second trimester (3.0 mU/L). Twenty percent of the TSH values are at or above a less restrictive 98th percentile of normal in the first trimester, as opposed to 23% of the values in the second trimester. Mean TSH levels are higher in women with antibodies. Free thyroxine values are unremarkable. Conclusion: Future strategies should focus on more effectively treating women with hypothyroidism who have persistently elevated TSH values.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume199
Issue number2
DOIs
StatePublished - Aug 2008

Fingerprint

Second Pregnancy Trimester
Thyrotropin
First Pregnancy Trimester
Hypothyroidism
Thyroxine
Thyroid Gland
Antibodies
Guidelines
Aneuploidy
Self Report
Observational Studies
Pregnancy
Serum
Research
Population

Keywords

  • antibody
  • free thyroxine
  • hypothyroidism
  • pregnancy
  • TSH

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Sequential first- and second-trimester TSH, free thyroxine, and thyroid antibody measurements in women with known hypothyroidism : a FaSTER trial study. / McClain, Monica R.; Lambert-Messerlian, Geralyn; Haddow, James E.; Palomaki, Glenn E.; Canick, Jacob A.; Cleary-Goldman, Jane; Malone, Fergal D.; Porter, T. Flint; Nyberg, David A.; Bernstein, Peter S.; D'Alton, Mary E.

In: American Journal of Obstetrics and Gynecology, Vol. 199, No. 2, 08.2008.

Research output: Contribution to journalArticle

McClain, MR, Lambert-Messerlian, G, Haddow, JE, Palomaki, GE, Canick, JA, Cleary-Goldman, J, Malone, FD, Porter, TF, Nyberg, DA, Bernstein, PS & D'Alton, ME 2008, 'Sequential first- and second-trimester TSH, free thyroxine, and thyroid antibody measurements in women with known hypothyroidism: a FaSTER trial study', American Journal of Obstetrics and Gynecology, vol. 199, no. 2. https://doi.org/10.1016/j.ajog.2008.02.036
McClain, Monica R. ; Lambert-Messerlian, Geralyn ; Haddow, James E. ; Palomaki, Glenn E. ; Canick, Jacob A. ; Cleary-Goldman, Jane ; Malone, Fergal D. ; Porter, T. Flint ; Nyberg, David A. ; Bernstein, Peter S. ; D'Alton, Mary E. / Sequential first- and second-trimester TSH, free thyroxine, and thyroid antibody measurements in women with known hypothyroidism : a FaSTER trial study. In: American Journal of Obstetrics and Gynecology. 2008 ; Vol. 199, No. 2.
@article{5bf58514715344d9beb01406c4099e1a,
title = "Sequential first- and second-trimester TSH, free thyroxine, and thyroid antibody measurements in women with known hypothyroidism: a FaSTER trial study",
abstract = "Objective: The purpose of this study was to examine how closely hypothyroidism management in the general pregnancy population satisfies recently issued guidelines and to determine whether improvements are indicated. Study Design: This was an observational study in which women at 5 recruitment centers in the first- and second-trimester evaluation of risk for aneuploidy trial allowed the use of sequentially obtained first- and second-trimester sera for additional research. Three hundred eighty-nine women had hypothyroidism by self-report. Thyroid-related measurements were performed on all samples between July 2004 and May 2005. Results: Forty-three percent of the thyroid-stimulating hormone (TSH) values are at or above recently recommended guidelines in the first trimester (2.5 mU/L), as opposed to 33{\%} of the values in the second trimester (3.0 mU/L). Twenty percent of the TSH values are at or above a less restrictive 98th percentile of normal in the first trimester, as opposed to 23{\%} of the values in the second trimester. Mean TSH levels are higher in women with antibodies. Free thyroxine values are unremarkable. Conclusion: Future strategies should focus on more effectively treating women with hypothyroidism who have persistently elevated TSH values.",
keywords = "antibody, free thyroxine, hypothyroidism, pregnancy, TSH",
author = "McClain, {Monica R.} and Geralyn Lambert-Messerlian and Haddow, {James E.} and Palomaki, {Glenn E.} and Canick, {Jacob A.} and Jane Cleary-Goldman and Malone, {Fergal D.} and Porter, {T. Flint} and Nyberg, {David A.} and Bernstein, {Peter S.} and D'Alton, {Mary E.}",
year = "2008",
month = "8",
doi = "10.1016/j.ajog.2008.02.036",
language = "English (US)",
volume = "199",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Sequential first- and second-trimester TSH, free thyroxine, and thyroid antibody measurements in women with known hypothyroidism

T2 - a FaSTER trial study

AU - McClain, Monica R.

AU - Lambert-Messerlian, Geralyn

AU - Haddow, James E.

AU - Palomaki, Glenn E.

AU - Canick, Jacob A.

AU - Cleary-Goldman, Jane

AU - Malone, Fergal D.

AU - Porter, T. Flint

AU - Nyberg, David A.

AU - Bernstein, Peter S.

AU - D'Alton, Mary E.

PY - 2008/8

Y1 - 2008/8

N2 - Objective: The purpose of this study was to examine how closely hypothyroidism management in the general pregnancy population satisfies recently issued guidelines and to determine whether improvements are indicated. Study Design: This was an observational study in which women at 5 recruitment centers in the first- and second-trimester evaluation of risk for aneuploidy trial allowed the use of sequentially obtained first- and second-trimester sera for additional research. Three hundred eighty-nine women had hypothyroidism by self-report. Thyroid-related measurements were performed on all samples between July 2004 and May 2005. Results: Forty-three percent of the thyroid-stimulating hormone (TSH) values are at or above recently recommended guidelines in the first trimester (2.5 mU/L), as opposed to 33% of the values in the second trimester (3.0 mU/L). Twenty percent of the TSH values are at or above a less restrictive 98th percentile of normal in the first trimester, as opposed to 23% of the values in the second trimester. Mean TSH levels are higher in women with antibodies. Free thyroxine values are unremarkable. Conclusion: Future strategies should focus on more effectively treating women with hypothyroidism who have persistently elevated TSH values.

AB - Objective: The purpose of this study was to examine how closely hypothyroidism management in the general pregnancy population satisfies recently issued guidelines and to determine whether improvements are indicated. Study Design: This was an observational study in which women at 5 recruitment centers in the first- and second-trimester evaluation of risk for aneuploidy trial allowed the use of sequentially obtained first- and second-trimester sera for additional research. Three hundred eighty-nine women had hypothyroidism by self-report. Thyroid-related measurements were performed on all samples between July 2004 and May 2005. Results: Forty-three percent of the thyroid-stimulating hormone (TSH) values are at or above recently recommended guidelines in the first trimester (2.5 mU/L), as opposed to 33% of the values in the second trimester (3.0 mU/L). Twenty percent of the TSH values are at or above a less restrictive 98th percentile of normal in the first trimester, as opposed to 23% of the values in the second trimester. Mean TSH levels are higher in women with antibodies. Free thyroxine values are unremarkable. Conclusion: Future strategies should focus on more effectively treating women with hypothyroidism who have persistently elevated TSH values.

KW - antibody

KW - free thyroxine

KW - hypothyroidism

KW - pregnancy

KW - TSH

UR - http://www.scopus.com/inward/record.url?scp=47949126441&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47949126441&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2008.02.036

DO - 10.1016/j.ajog.2008.02.036

M3 - Article

VL - 199

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 2

ER -