Variability in thyroid-stimulating hormone suppression by human chronic gonadotropin during early pregnancy

James E. Haddow, Monica R. McClain, Geralyn Lambert-Messerlian, 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

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Abstract

Objective: The objective of the study was to further explore relationships between human chorionic gonadotropin (hCG), TSH, and free T4 in pregnant women at 11 through 18 wk gestation. Study Design: The design of the study was to analyze hCG in comparison with TSH and free T4, in paired first- and second-trimester sera from 9562 women in the First and Second Trimester Evaluation of Risk for Fetal Aneuploidy trial study. Results: hCG is strongly correlated with body mass index, smoking, and gravidity. Correlations with selected maternal covariates also exist for TSH and free T4. As hCG deciles increase, body mass index and percent of women who smoke both decrease, whereas the percent of primigravid women increases (P < 0.0001). hCG/TSH correlations are weak in both trimesters (r2 = 0.03 and r2 = 0.02). TSH concentrations at the 25th and fifth centiles become sharply lower at higher hCG levels, whereas 50th centile and above TSH concentrations are only slightly lower. hCG/free T4 correlations are weak in both trimesters (r2 = 0.06 and r2 = 0.003). At 11-13 wk gestation, free T4 concentrations rise uniformly at all centiles, as hCG increases (test for trend, P < 0.0001), but not at 15-18 wk gestation. Multivariate analyses with TSH and free T4 as dependent variables and selected maternal covariates and hCG as independent variables do not alter these observations. Conclusions: In early pregnancy, a woman's centile TSH level appears to determine susceptibility to the TSH being suppressed at any given hCG level, suggesting that hCG itself may be the primary analyte responsible for stimulating the thyroid gland. hCG affects lower centile TSH values disproportionately.

Original languageEnglish (US)
Pages (from-to)3341-3347
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume93
Issue number9
DOIs
StatePublished - Sep 2008

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Thyrotropin
Chorionic Gonadotropin
Gonadotropins
Pregnancy
Second Pregnancy Trimester
First Pregnancy Trimester
Body Mass Index
Mothers
Gravidity
Aneuploidy
Smoke
Pregnant Women
Thyroid Gland
Multivariate Analysis
Smoking

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Haddow, J. E., McClain, M. R., Lambert-Messerlian, G., Palomaki, G. E., Canick, J. A., Cleary-Goldman, J., ... D'Alton, M. E. (2008). Variability in thyroid-stimulating hormone suppression by human chronic gonadotropin during early pregnancy. Journal of Clinical Endocrinology and Metabolism, 93(9), 3341-3347. https://doi.org/10.1210/jc.2008-0568

Variability in thyroid-stimulating hormone suppression by human chronic gonadotropin during early pregnancy. / Haddow, James E.; McClain, Monica R.; Lambert-Messerlian, Geralyn; 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: Journal of Clinical Endocrinology and Metabolism, Vol. 93, No. 9, 09.2008, p. 3341-3347.

Research output: Contribution to journalArticle

Haddow, JE, McClain, MR, Lambert-Messerlian, G, Palomaki, GE, Canick, JA, Cleary-Goldman, J, Malone, FD, Porter, TF, Nyberg, DA, Bernstein, PS & D'Alton, ME 2008, 'Variability in thyroid-stimulating hormone suppression by human chronic gonadotropin during early pregnancy', Journal of Clinical Endocrinology and Metabolism, vol. 93, no. 9, pp. 3341-3347. https://doi.org/10.1210/jc.2008-0568
Haddow, James E. ; McClain, Monica R. ; Lambert-Messerlian, Geralyn ; 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. / Variability in thyroid-stimulating hormone suppression by human chronic gonadotropin during early pregnancy. In: Journal of Clinical Endocrinology and Metabolism. 2008 ; Vol. 93, No. 9. pp. 3341-3347.
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AU - Cleary-Goldman, Jane

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