{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:32Z","timestamp":1740126812509,"version":"3.37.3"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Thyroid screening is recommended during pregnancy with serum thyrotropin (TSH) as\n                    the primary test. However, since human chorionic gonadotropin, the serum\n                    hallmark of pregnancy, has TSH-like effects, the adequacy of TSH as a screening\n                    tool in this constellation requires further study. This study aimed to evaluate\n                    the relationship between TSH and thyroid hormones during pregnancy in order to\n                    determine if TSH is an adequate screening tool. This was a retrospective study\n                    utilizing the Clalit Health Service, Jerusalem district database between\n                    2006\u20132017 in which we analyzed TSH, FT4 and FT3 measurements from 32430\n                    pregnancies resulting in live birth. We grouped FT4 and FT3 levels by trimester\n                    and by the following TSH levels: (1) below\n                    0.1\/0.2\/0.3\u2009mIU\/l, (2)\n                    0.1\u20132.5\/0.2\u20133.0\/0.3\u20133.0\u2009mIU\/l,\n                    (3) 2.6\u20134.0\/3.1\u20134.0\u2009mIU\/l, (4)\n                    4.1\u201310.0\u2009mIU\/l and (5) above 10.0\u2009mIU\/l.\n                    In the first trimester, the most important for fetal brain development, FT3 was\n                    below normal, defined as below the 2.5th percentile for the population, in only\n                    15.3% of tests with TSH over 10\u2009mIU\/l. FT4 was below\n                    normal in only 12.8% of such tests. Similar findings were noted for the\n                    second and third trimesters. As expected, there were far less abnormal tests\n                    when lower TSH cutoff levels were tested. In conclusion, TSH levels beyond the\n                    range accepted as normal do not, in most cases, reflect abnormal thyroid hormone\n                    levels during pregnancy. TSH is not a good screen for overt hypothyroidism in\n                    pregnancy. This may be due, at least in the first trimester, to thyrotropic\n                    effects of HCG.<\/jats:p>","DOI":"10.1055\/a-1872-0246","type":"journal-article","created":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T23:05:26Z","timestamp":1657839926000},"page":"435-441","source":"Crossref","is-referenced-by-count":2,"title":["Is TSH a Reliable Indicator of Thyroid Hormone Status in\n                    Pregnancy?"],"prefix":"10.1055","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1848-4560","authenticated-orcid":false,"given":"Gilad","family":"Karavani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical\n                    Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem,\n                    Israel"},{"name":"Infertility and IVF Unit, Hadassah Ein-Kerem Medical Center and Faculty\n                    of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Daoud-Sabag","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical\n                    Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem,\n                    Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cherut","family":"Chay","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Technion Israel Institute of Technology\n                    Ruth and Bruce Rappaport Faculty of Medicine, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gillis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hadassah-Hebrew University Medical Center,\n                    Jerusalem, Israel"},{"name":"Faculty of Medicine, Hebrew University of Jerusalem,\n                    Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Strich","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hebrew University of Jerusalem,\n                    Jerusalem, Israel"},{"name":"Pediatrics, Shaare Zedek Medical Center, Jerusalem,\n                    Israel"},{"name":"Pediatric Specialties, Shaare Zedek Medical Center, Jerusalem,\n                    Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,7,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/01.AOG.0000152345.99421.22","article-title":"Subclinical hypothyroidism and pregnancy outcomes","volume":"105","author":"B M Casey","year":"2005","journal-title":"Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1136\/jms.7.3.127","article-title":"Maternal thyroid deficiency and pregnancy complications: implications for\n                    population screening","volume":"7","author":"W C Allan","year":"2000","journal-title":"J Med Screen"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"2952","DOI":"10.1007\/s12035-018-1270-y","article-title":"Hypothyroidism and cognitive disorders during development and adulthood:\n                    implications in the central nervous system","volume":"56","author":"P Salazar","year":"2019","journal-title":"Mol Neurobiol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1530\/EJE-07-0249","article-title":"Evaluation of maternal thyroid function during pregnancy: the importance of\n                    using gestational age-specific reference intervals","volume":"157","author":"R Stricker","year":"2007","journal-title":"Eur J Endocrinol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1210\/jcem-73-4-824","article-title":"Pregnancy-induced changes in thyroid function: role of human chorionic\n                    gonadotropin as putative regulator of maternal thyroid","volume":"73","author":"M Ballabio","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1089\/105072503321086962","article-title":"Laboratory medicine practice guidelines: laboratory support for the diagnosis\n                    and monitoring of thyroid disease","volume":"13","author":"L M Demers","year":"2003","journal-title":"Thyroid"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1093\/bmb\/ldq039","article-title":"Thyroid function in pregnancy","volume":"97","author":"H Lazarus John","year":"2011","journal-title":"Br Med Bull"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1089\/thy.2016.0457","article-title":"2017 Guidelines of the American thyroid association for the diagnosis and\n                    management of thyroid disease during pregnancy and the postpartum","volume":"27","author":"E K Alexander","year":"2017","journal-title":"Thyroid"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1210\/edrv.18.3.0300","article-title":"The regulation of thyroid function in pregnancy: pathways of endocrine\n                    adaptation from physiology to pathology","volume":"18","author":"D Glinoer","year":"1997","journal-title":"Endocr Rev"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"260.e1","DOI":"10.1016\/j.ajog.2008.10.042","article-title":"Free T4 immunoassays are flawed during pregnancy","volume":"200","author":"R H Lee","year":"2009","journal-title":"Am J Obstet Gynecol"},{"volume-title":"Hypothyroidism during pregnancy: Clinical manifestations, diagnosis, and\n                    treatment. In: UpToDate, Post TW (ed), UpToDate","year":"2021","author":"SR Douglas","key":"ref11"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/j.1365-3016.2007.00862.x","article-title":"A comparison of LMP-based and ultrasound-based estimates of gestational age\n                    using linked California livebirth and prenatal screening records","volume":"13","author":"P M Dietz","year":"2007","journal-title":"Paediatr Perinat Epidemiol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"i6865","DOI":"10.1136\/bmj.i6865","article-title":"Thyroid hormone treatment among pregnant women with subclinical hypothyroidism:\n                    US national assessment","volume":"356","author":"S Maraka","year":"2017","journal-title":"BMJ"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/AOG.0b013e3181788dd7","article-title":"Maternal thyroid hypofunction and pregnancy outcome","volume":"112","author":"J Cleary-Goldman","year":"2008","journal-title":"Obstet Gynecol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1001\/jama.2019.10931","article-title":"Association of Thyroid Function Test Abnormalities and Thyroid Autoimmunity With\n                    Preterm Birth: A Systematic Review and Meta-analysis","volume":"322","author":"TI M Korevaar","year":"2019","journal-title":"JAMA"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1258\/0004563011900830","article-title":"Reference intervals for thyroid hormones in pregnant Chinese women","volume":"38","author":"N S Panesar","year":"2001","journal-title":"Ann Clin Biochem"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"250","DOI":"10.5694\/j.1326-5377.2008.tb02015.x","article-title":"Assessment of thyroid function during pregnancy: first-trimester (weeks\n                    9\u201313) reference intervals derived from Western Australian women","volume":"189","author":"R M Gilbert","year":"2008","journal-title":"Med J Aust"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"e22344","DOI":"10.1002\/jcla.22344","article-title":"Reference intervals of trimester- specific thyroid stimulating hormone and free\n                    thyroxine in Chinese women established by experimental and statistical\n                    methods","volume":"32","author":"L Han","year":"2018","journal-title":"J Clin Lab Anal"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1210\/er.2009-0041","article-title":"Thyroid function and human reproductive health","volume":"31","author":"G E Krassas","year":"2010","journal-title":"Endocr Rev"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1872-0246.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T23:07:02Z","timestamp":1657840022000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1872-0246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":19,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2022,7,14]]},"published-print":{"date-parts":[[2022,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1872-0246","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"type":"print","value":"0018-5043"},{"type":"electronic","value":"1439-4286"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}