{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:42:21Z","timestamp":1780569741576,"version":"3.54.1"},"reference-count":32,"publisher":"The Endocrine Society","issue":"9","funder":[{"name":"This project has been supported by the Exchange in Endocrinology Expertise (3E) program of the European Union of Medical Specialists (UEMS), Section and Board of Endocrinology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Establishing reference ranges as well as identifying and quantifying the determinants of thyroid function during pregnancy is important for proper clinical interpretation and optimizing research efforts. However, such data are sparse, specifically for triiodothyronine measurements, and most studies do not take into account thyroid antibodies or human chorionic gonadotropin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine reference ranges and to identify\/quantify determinants of TSH, free T4 (FT4), free triiodothyronine (FT3), total T4 (TT4), and total triiodothyronine (TT3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This study included 2314 participants of the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study, a population-based prospective pregnancy cohort of mother-child pairs. Reference ranges were calculated by 2.5th to 97.5th percentiles after excluding thyroperoxidase antibody (TPOAb)\u2013positive and\/or thyroglobulin antibody (TgAb)\u2013positive women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>None.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>TSH, FT4, FT3, TT4, and TT3 in prenatal serum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After exclusion of TPOAb-positive women, reference ranges were as follows: TSH, 0.11 to 3.48 mU\/L; FT4, 11.6 to 19.4 pmol\/L; FT3, 3.72 to 5.92 pg\/mL; TT4, 82.4 to 166.2 pmol\/L; and TT3, 1.28 to 2.92 nmol\/L. Additional exclusion of TgAb-positive women did not change the reference ranges substantially. Exposure to tobacco smoke, as assessed by questionnaires and serum cotinine, was associated with lower TSH and higher FT3 and TT3. Body mass index (BMI) and gestational age were the main determinants of TSH (only for BMI), FT4, FT3, TT4, and TT3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We show that the exclusion of TgAb-positive women on top of excluding TPOAb-positive women hardly affects clinical reference ranges. We identified various relevant clinical determinants of TSH, FT4, FT3, TT4, and TT3 that could reflect endocrine-disrupting effects and\/or effects on thyroid hormone transport or deiodination.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2018-00890","type":"journal-article","created":{"date-parts":[[2018,7,2]],"date-time":"2018-07-02T18:13:06Z","timestamp":1530555186000},"page":"3548-3556","source":"Crossref","is-referenced-by-count":36,"title":["Reference Ranges and Determinants of Thyroid Function During Early Pregnancy: The SELMA Study"],"prefix":"10.1210","volume":"103","author":[{"given":"Arash","family":"Derakhshan","sequence":"first","affiliation":[{"name":"Academic Center for Thyroid Diseases, Erasmus MC, GE Rotterdam, Netherlands"},{"name":"Department of Internal Medicine, Erasmus MC, GE Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Environmental Science and Analytical Chemistry, Stockholm University, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten A C","family":"Broeren","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Chemistry and Haematology, M\u00e1xima Medical Centre, Veldhoven, DB Veldhoven, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph A","family":"de Poortere","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Chemistry and Haematology, M\u00e1xima Medical Centre, Veldhoven, DB Veldhoven, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sverre","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, \u00d6rebro University, \u00d6rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin P","family":"Peeters","sequence":"additional","affiliation":[{"name":"Academic Center for Thyroid Diseases, Erasmus MC, GE 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