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 Bernstein, Mary E. D'Alton

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

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)
Pages (from-to)129.e1-129.e6
JournalAmerican journal of obstetrics and gynecology
Volume199
Issue number2
DOIs
StatePublished - Aug 2008

Keywords

  • TSH
  • antibody
  • free thyroxine
  • hypothyroidism
  • pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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