{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:36:11Z","timestamp":1772138171490,"version":"3.50.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T00:00:00Z","timestamp":1692662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009367","name":"Mansoura University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009367","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hormones"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>We aimed to clarify the influence of thyroid autoantibodies at various clinical stages of hypothyroidism on the risk of pregnancy loss before 20 weeks of gestation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We enrolled 230 pregnant women with a history of recurrent miscarriage. Detailed clinical history, physical examination, and laboratory testing of thyroid function, antithyroid peroxidase (anti-TPO), and antithyroglobulin (anti-TG) were applied among all participants.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Coexisting overt hypothyroidism and positive thyroid autoantibodies quadrupled the risk of miscarriage in women before 20 weeks of gestation (OR 4.04, 95% CI = 2.08\u20137.96, <jats:italic>P<\/jats:italic> &lt; 0.001). Women with subclinical hypothyroidism (OR 1.44, 95% CI = 0.81\u20132.57, <jats:italic>P<\/jats:italic> = 0.132,) or who were euthyroid (OR 1.53, 95% CI = 0.86\u20132.73, <jats:italic>P<\/jats:italic> = 0.094) showed a non-significant risk of miscarriage even with positive thyroid autoantibodies. Thyroid-stimulating hormone (TSH) was positively correlated with the number of miscarriages rather than anti-TPO (<jats:italic>P<\/jats:italic> &lt; 0.001 and 0.209, respectively).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Coexistence of overt hypothyroidism and thyroid autoimmunity was the only significant driver of pregnancy loss before 20 weeks of gestation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s42000-023-00474-2","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T15:02:50Z","timestamp":1692716570000},"page":"587-593","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Influence of thyroid autoimmunity at various clinical stages of hypothyroidism on the risk of miscarriage before 20 weeks of gestation"],"prefix":"10.1007","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-6451","authenticated-orcid":false,"given":"Mohammed Ali","family":"Gameil","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5551-1540","authenticated-orcid":false,"given":"Rehab Elsayed","family":"Marzouk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1061-4658","authenticated-orcid":false,"given":"Ahmed Hassan","family":"Elsebaie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Abd EL-Hakim","family":"Arafat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed Ibrahim Abd","family":"El-Ghany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,8,22]]},"reference":[{"issue":"2","key":"474_CR1","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1530\/EJE-14-0100","volume":"171","author":"IZ Ahmed","year":"2014","unstructured":"Ahmed IZ, Eid YM, El Orabi H, Ibrahim HR (2014) Comparison of universal and targeted screening for thyroid dysfunction in pregnant Egyptian women. Eur J Endocrinol 171(2):285\u2013291. https:\/\/doi.org\/10.1530\/EJE-14-0100","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"474_CR2","doi-asserted-by":"publisher","first-page":"96","DOI":"10.3390\/medicina57020096","volume":"57","author":"MS Godines-Enriquez","year":"2021","unstructured":"Godines-Enriquez MS, Miranda-Vel\u00e1squez S, Enr\u00edquez-P\u00e9rez MM, Arce-S\u00e1nchez L, Mart\u00ednez-Cruz N, Flores-Robles CM et al (2021) Prevalence of thyroid autoimmunity in women with recurrent pregnancy loss. Medicina (Kaunas) 57(2):96. https:\/\/doi.org\/10.3390\/medicina57020096","journal-title":"Medicina (Kaunas)"},{"issue":"5","key":"474_CR3","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1093\/humupd\/dmr024","volume":"17","author":"E van den Boogaard","year":"2011","unstructured":"van den Boogaard E, Vissenberg R, Land JA, van Wely M, van der Post JAM, Goddijn M, Bisschop PH (2011) Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update 17(5):605\u201319. https:\/\/doi.org\/10.1093\/humupd\/dmr024","journal-title":"Hum Reprod Update"},{"issue":"2","key":"474_CR4","doi-asserted-by":"publisher","first-page":"121","DOI":"10.7150\/ijms.3467","volume":"9","author":"Y Zhong","year":"2012","unstructured":"Zhong Y, Ying Y, Wu H, Zhou C, Xu Y, Wang Q et al (2012) Relationship between antithyroid antibody and pregnancy outcome following in vitro fertilization and embryo transfer. Int J Med Sci 9(2):121\u2013125. https:\/\/doi.org\/10.7150\/ijms.3467","journal-title":"Int J Med Sci"},{"issue":"2","key":"474_CR5","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1097\/AOG.0b013e3181e904e5","volume":"116","author":"M Abbassi-Ghanavati","year":"2010","unstructured":"Abbassi-Ghanavati M, Casey BM, Spong CY, McIntire DD, Halvorson LM, Cunningham G et al (2010) Pregnancy outcomes in women with thyroid peroxidase antibodies. Obstet Gynecol 116(2):381\u2013386. https:\/\/doi.org\/10.1097\/AOG.0b013e3181e904e5","journal-title":"Obstet Gynecol"},{"issue":"3","key":"474_CR6","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1007\/s13224-014-0657-6","volume":"66","author":"A Meena","year":"2016","unstructured":"Meena A, Nagar P (2016) Pregnancy outcome in euthyroid women with anti-thyroid peroxidase antibodies. J Obstet Gynaecol India 66(3):160\u2013165. https:\/\/doi.org\/10.1007\/s13224-014-0657-6","journal-title":"J Obstet Gynaecol India"},{"issue":"2\u20133","key":"474_CR7","doi-asserted-by":"publisher","first-page":"J275","DOI":"10.1016\/j.jaut.2011.11.014","volume":"38","author":"G Twig","year":"2012","unstructured":"Twig G, Shina A, Amital H, Shoenfeld Y (2012) Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity. J Autoimmun 38(2\u20133):J275\u2013J281. https:\/\/doi.org\/10.1016\/j.jaut.2011.11.014","journal-title":"J Autoimmun"},{"key":"474_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjopen-2018-022837","volume":"18","author":"J Yamamoto","year":"2018","unstructured":"Yamamoto J, Benham J, Nerenberg K, Donovan L (2018) Impact of levothyroxine therapy on obstetric, neonatal and childhood outcomes in women with subclinical hypothyroidism diagnosed in pregnancy; a systematic review and meta-analysis of randomized controlled trials. BMJ Open 18:1\u201310. https:\/\/doi.org\/10.1136\/bmjopen-2018-022837 [PMC free article] [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"BMJ Open"},{"issue":"7","key":"474_CR9","doi-asserted-by":"publisher","first-page":"2587","DOI":"10.1210\/jc.2005-1603","volume":"91","author":"R Negro","year":"2006","unstructured":"Negro R, Formoso G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H et al (2006) Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab 91(7):2587\u20132591. https:\/\/doi.org\/10.1210\/jc.2005-1603","journal-title":"J Clin Endocrinol Metab"},{"key":"474_CR10","doi-asserted-by":"publisher","first-page":"2596","DOI":"10.1186\/s12884-019-2596-9","volume":"19","author":"Z Kiran","year":"2019","unstructured":"Kiran Z, Sheikh A, Malik S, Meraj A, Masood M, Ismail S et al (2019) Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (maternal hypothyroidism on pregnancy outcomes, MHPO-1). BMV. 19:2596\u20132599. https:\/\/doi.org\/10.1186\/s12884-019-2596-9 [PMC free article] [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"BMV."},{"key":"474_CR11","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1002\/ijgo.12745","volume":"144","author":"GC Di Renzo","year":"2019","unstructured":"Di Renzo GC (2019) Good clinical practice advice: thyroid and pregnancy. Int J Gynecol Obs 144:347\u2013351 [Google Scholar] [Ref list]","journal-title":"Int J Gynecol Obs"},{"issue":"1","key":"474_CR12","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.fertnstert.2012.09.023","volume":"99","author":"Practice Committee of American Society for Reproductive Medicine","year":"2013","unstructured":"Practice Committee of American Society for Reproductive Medicine (2013) Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertil Steril.,2012 99(1):63. https:\/\/doi.org\/10.1016\/j.fertnstert.2012.09.023","journal-title":"Fertil Steril.,2012"},{"key":"474_CR13","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1111\/j.1447-0756.2009.01079.x","volume":"35","author":"J Kwak-Kim","year":"2009","unstructured":"Kwak-Kim J, Yang KM, Gilman-Sachs A (2009) Recurrent pregnancy loss: a disease of inflammation and coagulation. J Obs Gynaecol Res 35:609\u2013622. https:\/\/doi.org\/10.1111\/j.1447-0756.2009.01079.x [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"J Obs Gynaecol Res"},{"key":"474_CR14","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1016\/j.fertnstert.2009.01.166","volume":"93","author":"CR Jaslow","year":"2010","unstructured":"Jaslow CR, Carney JL, Kutteh WH (2010) Diagnostic factors identified in 1020 women with two versus three or more recurrent pregnancy losses. Fertil. Steril. 93:1234\u20131243. https:\/\/doi.org\/10.1016\/j.fertnstert.2009.01.166 [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"Fertil. Steril."},{"issue":"3","key":"474_CR15","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1089\/thy.2016.0457","volume":"27","author":"EK Alexander","year":"2017","unstructured":"Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C et al (2017) 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 27(3):315\u2013389","journal-title":"Thyroid"},{"key":"474_CR16","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1111\/j.1365-2265.2010.03974.x","volume":"74","author":"L Chen","year":"2011","unstructured":"Chen L, Hu R (2011) Thyroid autoimmunity and miscarriage: a meta-analysis. Clin. Endocrinol 74:513\u2013519. https:\/\/doi.org\/10.1111\/j.1365-2265.2010.03974.x [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"Clin. Endocrinol"},{"issue":"8","key":"474_CR17","doi-asserted-by":"publisher","first-page":"dgaa302","DOI":"10.1210\/clinem\/dgaa302","volume":"105","author":"RK Dhillon-Smith","year":"2020","unstructured":"Dhillon-Smith RK, Tobias A, Smith PP, Middleton LJ, Sunner KK, Baker K et al (2020) The prevalence of thyroid dysfunction and autoimmunity in women with history of miscarriage or subfertility. J Clin Endocrinol Metab 105(8):dgaa302. https:\/\/doi.org\/10.1210\/clinem\/dgaa302","journal-title":"J Clin Endocrinol Metab"},{"issue":"7","key":"474_CR18","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1089\/thy.2022.0083","volume":"32","author":"S Bliddal","year":"2022","unstructured":"Bliddal S, Derakhshan A, Xiao Y, Chen LM, M\u00e4nnist\u00f6 T, Ashoor G et al (2022 Jul) (2022). Association of thyroid peroxidase antibodies and thyroglobulin antibodies with thyroid function in pregnancy: an individual participant data meta-analysis. Thyroid 32(7):828\u2013840","journal-title":"Thyroid"},{"issue":"2","key":"474_CR19","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1530\/ec-13-0012","volume":"2","author":"K Lata","year":"2013","unstructured":"Lata K, Dutta P, Sridhar S, Rohilla M, Srinivasan A, Prashad G et al (2013) Thyroid autoimmunity and obstetric outcomes in women with recurrent miscarriage: a case\u2013control study. Endocr Connect 2(2):118\u2013124. https:\/\/doi.org\/10.1530\/ec-13-0012","journal-title":"Endocr Connect"},{"issue":"9","key":"474_CR20","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1097\/SMJ.0b013e3182a66610","volume":"106","author":"S Ahmad","year":"2013","unstructured":"Ahmad S, Geraci SA, Koch CA (2013) Thyroid disease in pregnancy: (Women's Health Series). South Med J 106(9):532\u2013538","journal-title":"South Med J"},{"key":"474_CR21","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1210\/jc.2007-0141","volume":"92","author":"M Abalovich","year":"2007","unstructured":"Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D et al (2007) Management of thyroid dysfunction during pregnancy and postpartum: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 92:S1\u2013S7. https:\/\/doi.org\/10.1210\/jc.2007-0141 [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"474_CR22","doi-asserted-by":"publisher","first-page":"139","DOI":"10.3109\/07435800.2014.966384","volume":"40","author":"F Saki","year":"2015","unstructured":"Saki F, Dabbaghmanesh MH, Ghaemi SZ, Forouhari S, Omrani GR, Bakhshayeshkaram M (2015) Thyroid autoimmunity in pregnancy and its influences on maternal and fetal outcome in. Iran (a prospective study) Endocr Res 40(3):139\u2013145. https:\/\/doi.org\/10.3109\/07435800.2014.966384","journal-title":"Iran (a prospective study) Endocr Res"},{"key":"474_CR23","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1530\/eje.0.1500751","volume":"150","author":"MF Prummel","year":"2004","unstructured":"Prummel MF, Wiersinga WM (2004) Thyroid autoimmunity and miscarriage. Eur J Endocrinol 150:751\u2013755. https:\/\/doi.org\/10.1530\/eje.0.1500751 [PubMed] [CrossRef] [Google Scholar]","journal-title":"Eur J Endocrinol"},{"issue":"10","key":"474_CR24","doi-asserted-by":"publisher","first-page":"2925","DOI":"10.1210\/clinem\/dgac425","volume":"107","author":"JAJ Osinga","year":"2022","unstructured":"Osinga JAJ, Derakhshan A, Palomaki GE, Ashoor G, M\u00e4nnist\u00f6 T, Maraka S et al (2022 Sep 28) (2022). TSH and FT4 reference intervals in pregnancy: a systematic review and individual participant data meta-analysis. J Clin Endocrinol Metab. 107(10):2925\u20132933","journal-title":"J Clin Endocrinol Metab."},{"key":"474_CR25","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.fertnstert.2019.11.003","volume":"113","author":"AC Dong","year":"2020","unstructured":"Dong AC, Morgan J, Kane M, Stagnaro-Green A, Stephenson MD (2020) Subclinical hypothyroidism and thyroid autoimmunity in recurrent pregnancy loss: a systematic review and meta-analysis. Fertil. Steril 113:587\u2013600. https:\/\/doi.org\/10.1016\/j.fertnstert.2019.11.003 [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"Fertil. Steril"},{"issue":"6","key":"474_CR26","doi-asserted-by":"publisher","first-page":"2358","DOI":"10.1210\/jc.2016-1049","volume":"101","author":"TC Plowden","year":"2016","unstructured":"Plowden TC, Schisterman EF, Sjaarda LA, Zarek SM, Perkins NJ, Silver R et al (2016) Subclinical hypothyroidism and thyroid autoimmunity are not associated with fecundity, pregnancy loss, or live birth. J Clin Endocrinol Metab 101(6):2358\u20132365","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"474_CR27","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1089\/thy.2019.0199","volume":"30","author":"G Sitoris","year":"2019","unstructured":"Sitoris G, Veltri F, Kleynen P, Cogan A, Belhomme J, Rozenberg S et al (2019) The impact of thyroid disorders on clinical pregnancy outcomes in a real-world study setting. Thyroid. 30(1):106\u2013115","journal-title":"Thyroid."},{"key":"474_CR28","doi-asserted-by":"publisher","unstructured":"Rao M, Zeng Z, Zhou F, Wang H, Liu J, Wang R et al (2019) Effect of levothyroxine supplementation on pregnancy loss and preterm birth in women with subclinical hypothyroidism and thyroid autoimmunity: a systematic review and meta-analysis Hum Reprod Update. 25(3):344\u2013361. https:\/\/doi.org\/10.1093\/humupd\/dmz003","DOI":"10.1093\/humupd\/dmz003"},{"key":"474_CR29","doi-asserted-by":"publisher","unstructured":"Negro R (2021) Outcomes in pregnant patients with subclinical hypothyroidism and thyroid autoimmunity: a critical appraisal of recent randomized controlled trials Endocr Metab Immune Disord Drug Targets. 21(8):1387\u20131391. https:\/\/doi.org\/10.2174\/1871530320999201116200153","DOI":"10.2174\/1871530320999201116200153"},{"issue":"11","key":"474_CR30","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1089\/thy.2014.0029","volume":"24","author":"H Liu","year":"2014","unstructured":"Liu H, Shan Z, Li C, Mao J, Xie X, Wang W et al (2014) Maternal subclinical hypothyroidism, thyroid autoimmunity, and the risk of miscarriage: a prospective cohort study. Thyroid 24(11):1642\u20131649. https:\/\/doi.org\/10.1089\/thy.2014.0029","journal-title":"Thyroid"},{"key":"474_CR31","doi-asserted-by":"publisher","unstructured":"Beneventi F, De Maggio I, Bellingeri C, Cavagnoli C, Spada C, Boschetti A et al (2022) Thyroid autoimmunity and adverse pregnancy outcomes: a prospective cohort study Endocrine. 76(1):198\u2013207. https:\/\/doi.org\/10.1007\/s12020-021-02958-w","DOI":"10.1007\/s12020-021-02958-w"},{"key":"474_CR32","doi-asserted-by":"publisher","unstructured":"Yuan N, Sun J, Li Z, Chai S, Zhang X, Linong J (2020) Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study BMC Pregnancy Childbirth. 20:491.Published online 2020 Aug 26. https:\/\/doi.org\/10.1186\/s12884-020-03176-4","DOI":"10.1186\/s12884-020-03176-4"},{"issue":"6","key":"474_CR33","doi-asserted-by":"publisher","first-page":"E920","DOI":"10.1210\/jc.2011-0026","volume":"96","author":"R Negro","year":"2011","unstructured":"Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A et al (2011) Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes. J Clin Endocrinol Metab 96(6):E920\u2013E924. https:\/\/doi.org\/10.1210\/jc.2011-0026","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"474_CR34","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1007\/s12020-014-0420-x","volume":"48","author":"LM Chen","year":"2015","unstructured":"Chen LM, Zhang Q, Si GX, Chen QS, Ye E-l, Yu L-C et al (2015) Associations between thyroid autoantibody status and abnormal pregnancy outcomes in euthyroid women. Endocrine 48(3):924\u2013928","journal-title":"Endocrine"},{"issue":"4","key":"474_CR35","doi-asserted-by":"publisher","first-page":"577","DOI":"10.4103\/ijem.IJEM_397_16","volume":"21","author":"R Rajput","year":"2017","unstructured":"Rajput R, Yadav T, Seth S, Nanda S (2017) Prevalence of thyroid peroxidase antibody and pregnancy outcome in euthyroid autoimmune positive pregnant women from a tertiary care center in Haryana. Indian J Endocrinol Metab 21(4):577. https:\/\/doi.org\/10.4103\/ijem.IJEM_397_16","journal-title":"Indian J Endocrinol Metab"},{"issue":"4","key":"474_CR36","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1530\/EJE-07-0249","volume":"157","author":"R Stricker","year":"2007","unstructured":"Stricker R, Echenard M, Eberhart R, Chevailler MC, Perez V, Quinn FA et al (2007) Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals. Eur J Endocrinol 157(4):509\u2013514. https:\/\/doi.org\/10.1530\/EJE-07-0249","journal-title":"Eur J Endocrinol"},{"key":"474_CR37","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.3892\/etm.2019.7739","volume":"18","author":"M Zhou","year":"2019","unstructured":"Zhou M, Wang M, Juming L, Xiaohui L, Minxianf L (2019) Effects of thyroid diseases on pregnancy outcomes. Exp Ther Med 18:1807\u20131815. https:\/\/doi.org\/10.3892\/etm.2019.7739 [PMC free article] [PubMed] [CrossRef] [Google Scholar] [Ref list]","journal-title":"Exp Ther Med"}],"container-title":["Hormones"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42000-023-00474-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s42000-023-00474-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42000-023-00474-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T01:13:02Z","timestamp":1700097182000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s42000-023-00474-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,22]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["474"],"URL":"https:\/\/doi.org\/10.1007\/s42000-023-00474-2","relation":{},"ISSN":["1109-3099","2520-8721"],"issn-type":[{"value":"1109-3099","type":"print"},{"value":"2520-8721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,22]]},"assertion":[{"value":"14 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board for Clinical Research committee of Mansoura University, Mansoura, Dakahlia, Egypt, with the approval code R.18.09.277. All procedures were in accordance with the ethical standards of the institutional research committee and with the 1975 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent was approved by the IRB and signed by all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}