{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T08:44:48Z","timestamp":1780044288568,"version":"3.53.1"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T00:00:00Z","timestamp":1529625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate predictors of low thyroid\u2010stimulating hormone (<jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>) persisting beyond the first trimester and associated pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively assessed the association between low first\u2010trimester <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> and obstetric outcomes of singleton pregnancies in southern Israel between 2001 and 2011. We included women with first\u2010trimester <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> and at least one other <jats:styled-content style=\"fixed-case\">THS<\/jats:styled-content> measurement. Clinical data were from maternity and community medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 3761 women, 185 (4.9%) had a <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> of 0.10\u00a0<jats:styled-content style=\"fixed-case\">mIU<\/jats:styled-content>\/L or less in the first trimester. Multiple of the median human chorionic gonadotropin was higher in women with <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> of 0.40\u00a0<jats:styled-content style=\"fixed-case\">mIU<\/jats:styled-content>\/L or less versus 0.41\u20134.0\u00a0<jats:styled-content style=\"fixed-case\">mIU<\/jats:styled-content>\/L, but was not associated with higher rates of persistent low <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>. Maternal age (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 1.08, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.00\u20131.16; per yearly increment), free thyroxine (<jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>4; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.11, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.03\u20131.20; per ng\/<jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content> increment), and <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> of 0.10\u00a0<jats:styled-content style=\"fixed-case\">mIU<\/jats:styled-content>\/L or less (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.06, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.38\u20136.80 vs 0.21\u20130.40\u00a0<jats:styled-content style=\"fixed-case\">mIU<\/jats:styled-content>\/L) were independent predictors of persistent low <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>. No adverse pregnancy outcomes occurred in women with low first\u2010trimester TSH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> persisting beyond the first trimester was more common with increasing maternal age, elevated <jats:styled-content style=\"fixed-case\">FT<\/jats:styled-content>4, and <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> below 0.10\u00a0<jats:styled-content style=\"fixed-case\">mIU<\/jats:styled-content>\/L, but was not associated with obstetric complications.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12540","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T11:15:58Z","timestamp":1527851758000},"page":"270-276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Low thyroid\u2010stimulating hormone and its persistence beyond the first trimester of pregnancy"],"prefix":"10.1002","volume":"142","author":[{"given":"Merav","family":"Fraenkel","sequence":"first","affiliation":[{"name":"Endocrinology Soroka University Medical Center and the Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tali","family":"Shafat","sequence":"additional","affiliation":[{"name":"Clinical Research Center Soroka University Medical Center and the Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avivit","family":"Cahn","sequence":"additional","affiliation":[{"name":"The Diabetes Unit, Endocrinology and Metabolism Unit Hadassah Hebrew University Hospital  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Offer","family":"Erez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology Soroka University Medical Center and the Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Novack","sequence":"additional","affiliation":[{"name":"Clinical Research Center Soroka University Medical Center and the Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat","family":"Tsur","sequence":"additional","affiliation":[{"name":"Endocrinology Clalit Health Services  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2803"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0087"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1748"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2010.91"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.75.5.1333"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2010.02.007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-71-2-276"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(13)70086-X"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0b013e3282ef45d3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2009-0041"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2011.07.010"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39462.709005.AE"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000357615"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-4233"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000152345.99421.22"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-107350"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1258\/0969141042467340"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2001.01353.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2397"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318250aeeb"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1506"}],"container-title":["International Journal of Gynecology &amp; 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