{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T08:45:28Z","timestamp":1649148328752},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2004,4]]},"abstract":"<jats:p>A gravidez \u00e9 acompanhada por uma s\u00e9rie de modifica\u00e7\u00f5es fisiol\u00f3gicas que incluem uma eleva\u00e7\u00e3o significativa da globulina ligadora de tiroxina (Thyroxine-Binding Globulin, TBG). Tal eleva\u00e7\u00e3o interfere nos n\u00edveis s\u00e9ricos totais da tiroxina (T4) e corrobora a utiliza\u00e7\u00e3o da medida de tiroxina livre (T4L), em conjunto com a dosagem de TSH, como m\u00e9todos de primeira linha para a avalia\u00e7\u00e3o de fun\u00e7\u00e3o tiroidiana na gravidez. Uma defini\u00e7\u00e3o cuidadosa dos valores normais de T4L durante a gesta\u00e7\u00e3o \u00e9 fundamental para o estudo de altera\u00e7\u00f5es da fun\u00e7\u00e3o tiroidiana, desde que disfun\u00e7\u00f5es m\u00ednimas podem resultar em anormalidades fetais significativas. Estudamos 132 gr\u00e1vidas normais, entre 6 e 38 semanas de gesta\u00e7\u00e3o, e os resultados da medida de T4L por m\u00e9todo indireto em duas etapas (valores normais de 0,7 a 1,5ng\/dL em n\u00e3o gr\u00e1vidas, n= 797) mostraram valores entre 0,5 e 1,3ng\/dL, com m\u00e9dia\u00b1DP de 0,78\u00b10,16ng\/dL, significativamente mais baixos que os observados em n\u00e3o gr\u00e1vidas (0,98\u00b10,14ng\/dL, P&lt;0,0001). Estes valores tendem a cair progressivamente ao longo da gesta\u00e7\u00e3o, observando-se uma correla\u00e7\u00e3o negativa significativa com os n\u00edveis de TBG (rs= -0,51, P&lt;0,0001), e com a idade gestacional (rs= -0,649, P&lt;0,0001). Os n\u00edveis de TSH n\u00e3o mostraram correla\u00e7\u00e3o com a idade gestacional. Nossos dados comprovam a necessidade de defini\u00e7\u00e3o mais rigorosa dos valores normais para T4L em mulheres gr\u00e1vidas, objetivando uma avalia\u00e7\u00e3o laboratorial mais precisa no diagn\u00f3stico e acompanhamento de disfun\u00e7\u00f5es tiroidianas nesse grupo de pacientes.<\/jats:p>","DOI":"10.1590\/s0004-27302004000200015","type":"journal-article","created":{"date-parts":[[2005,5,12]],"date-time":"2005-05-12T20:04:00Z","timestamp":1115928240000},"page":"305-309","source":"Crossref","is-referenced-by-count":4,"title":["Defini\u00e7\u00e3o de valores normais de tiroxina livre durante a gravidez"],"prefix":"10.1590","volume":"48","author":[{"given":"Jos\u00e9 Gilberto H.","family":"Vieira","sequence":"first","affiliation":[{"name":"Fleury Centro de Medicina Diagn\u00f3stica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ina","family":"Kanashiro","sequence":"additional","affiliation":[{"name":"Fleury Centro de Medicina Diagn\u00f3stica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresinha T.","family":"Tachibana","sequence":"additional","affiliation":[{"name":"Fleury Centro de Medicina Diagn\u00f3stica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Ghiringhello","sequence":"additional","affiliation":[{"name":"Fleury Centro de Medicina Diagn\u00f3stica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar M.","family":"Hauache","sequence":"additional","affiliation":[{"name":"Fleury Centro de Medicina Diagn\u00f3stica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui M.B.","family":"Maciel","sequence":"additional","affiliation":[{"name":"Fleury Centro de Medicina Diagn\u00f3stica"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1210\/edrv-11-1-5","article-title":"Measurement of free hormones in 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