{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:48:11Z","timestamp":1791460091247,"version":"4.3.4"},"reference-count":38,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Netherlands Organization for Scientific Research","award":["grant 401.16.020"],"award-info":[{"award-number":["grant 401.16.020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Interpretation of thyroid function tests during pregnancy is limited by the generalizability of reference intervals between cohorts due to inconsistent methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>(1) To provide an overview of published reference intervals for thyrotropin (TSH) and free thyroxine (FT4) in pregnancy, (2) to assess the consequences of common methodological between-study differences by combining raw data from different cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>(1) Ovid MEDLINE, EMBASE, and Web of Science were searched until December 12, 2021. Studies were assessed in duplicate. (2) The individual participant data (IPD) meta-analysis was performed in participating cohorts in the Consortium on Thyroid and Pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>(1) Large between-study methodological differences were identified, 11 of 102 included studies were in accordance with current guidelines; (2) 22 cohorts involving 63\u2005198 participants were included in the meta-analysis. Not excluding thyroid peroxidase antibody\u2013positive participants led to a rise in the upper limits of TSH in all cohorts, especially in the first (mean +17.4%; range +1.6 to +30.3%) and second trimester (mean +9.8%; range +0.6 to +32.3%). The use of the 95th percentile led to considerable changes in upper limits, varying from \u201310.8% to \u201321.8% for TSH and \u20131.2% to \u201313.2% for FT4. All other additional exclusion criteria changed reference interval cut-offs by a maximum of 3.5%. Applying these findings to the 102 studies included in the systematic review, 48 studies could be used in a clinical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We provide an overview of clinically relevant reference intervals for TSH and FT4 in pregnancy. The results of the meta-analysis indicate that future studies can adopt a simplified study setup without additional exclusion criteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgac425","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T10:38:59Z","timestamp":1658399939000},"page":"2925-2933","source":"Crossref","is-referenced-by-count":52,"title":["TSH and FT4 Reference Intervals in Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2527-5150","authenticated-orcid":false,"given":"Joris A J","family":"Osinga","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Erasmus University Medical Center , Rotterdam , The Netherlands"},{"name":"Academic Center for Thyroid Diseases, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7335-1918","authenticated-orcid":false,"given":"Arash","family":"Derakhshan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Erasmus University Medical Center , Rotterdam , The Netherlands"},{"name":"Academic Center for Thyroid Diseases, Erasmus University Medical Center , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn E","family":"Palomaki","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Women & Infants Hospital and Alpert Medical School at Brown University , Providence, RI 02905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghalia","family":"Ashoor","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Center for Fetal Medicine, King\u2019s College Hospital , London , 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