{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:37:57Z","timestamp":1791218277978,"version":"4.1.0"},"reference-count":31,"publisher":"The Endocrine Society","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Currently, there is no consensus on universal thyroid screening and levothyroxine (LT4) treatment of pregnant women with subclinical hypothyroidism (SCH) who are negative for thyroid peroxidase antibody (TPOAb\u2212).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to evaluate the benefits of LT4 treatment on pregnancy outcomes in SCH-TPOAb\u2212 women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This study was conducted within the framework of the Tehran Thyroid and Pregnancy Study. A single-blind randomized clinical trial was undertaken in pregnant women who were SCH-TPOAb\u2212.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Prenatal care centers of the Shahid Beheshti University of Medical Sciences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Using the thyrotropin (TSH) cut point of 2.5 mIU\/L, 366 SCH-TPOAb\u2212 and 1092 euthyroid TPOAb\u2212 women were recruited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>SCH-TPOAb\u2212 women were randomly assigned to two groups: group A (n = 183) who were treated with LT4 and group B (n = 183) who received no treatment. A total of 1,028 euthyroid TPOAb\u2212 women served as the control group (group C).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure<\/jats:title><jats:p>The primary outcome was the rate of preterm delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using the TSH cutoff of 2.5 mIU\/L, no significant difference in preterm delivery was observed between groups A and B [relative risk (RR): 0.86; 95% confidence interval (CI): 0.47 to 1.55; P = 0.61]. However, log-binomial model analysis based on a cut point of 4.0 mIU\/L demonstrated a significantly lower rate of preterm delivery in LT4-treated women compared with those who received no treatment (RR: 0.38; 95% CI: 0.15 to 0.98; P = 0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite no beneficial effect of LT4 therapy in reducing preterm delivery in SCH-TPOAb\u2212 women with a TSH cut point of 2.5 to 4 mIU\/L, LT4 could precisely decrease this complication using the newly recommended cutoff \u22654.0 mIU\/L.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2017-01850","type":"journal-article","created":{"date-parts":[[2017,11,6]],"date-time":"2017-11-06T19:07:20Z","timestamp":1509995240000},"page":"926-935","source":"Crossref","is-referenced-by-count":129,"title":["Effects of Levothyroxine on Pregnant Women With Subclinical Hypothyroidism, Negative for Thyroid Peroxidase Antibodies"],"prefix":"10.1210","volume":"103","author":[{"given":"Sima","family":"Nazarpour","sequence":"first","affiliation":[{"name":"Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran"},{"name":"Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahimeh","family":"Ramezani Tehrani","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoumeh","family":"Simbar","sequence":"additional","affiliation":[{"name":"Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Tohidi","sequence":"additional","affiliation":[{"name":"Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Minooee","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Rahmati","sequence":"additional","affiliation":[{"name":"Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereidoun","family":"Azizi","sequence":"additional","affiliation":[{"name":"Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2017,11,6]]},"reference":[{"issue":"3","key":"2020071620355370600_B1","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 management of thyroid disease during pregnancy and the postpartum","volume":"27","author":"Alexander","year":"2017","journal-title":"Thyroid"},{"issue":"8","key":"2020071620355370600_B2","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1210\/jc.2011-2803","article-title":"Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society 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