Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  16 (2024)
Volume  15 (2023)
Volume  14 (2022)
Volume  13 (2021)
Volume  12 (2020)
Volume  11 (2019)
Volume  10 (2018)
Volume  9 (2017)
Volume  8 (2016)
Volume  7 (2015)
Volume  6 (2014)
Volume  5 (2013)
Volume  4 (2012)
Volume  3 (2011)
Volume  2 (2010)
Volume  1 (2009)
Related articles

VOLUME 16 , ISSUE S3 ( December, 2024 ) > List of Articles

RESEARCH ARTICLE

Reference Interval for Free Thyroxine, Free Triiodothyronine, and Thyroid-stimulating Hormone in Singleton Pregnant Women in South Coastal Karnataka: An Observational Cross-sectional Study

Vidyashree G Poojari, Monalisa Biswas, Sairoz, Krishnananda Prabhu, Vijetha Shenoy Belle

Keywords : Pregnant woman, Reference interval, Thyroid profile

Citation Information : Poojari VG, Biswas M, Sairoz, Prabhu K, Belle VS. In Vitro Comparative Evaluation of Change in Mass, pH and Fluoride Release of Cention-N and Glass–Ionomer Cement. Cons Dent Endod J 2022; 7 (2):40-43.

DOI: 10.5005/jp-journals-10006-2568

License: CC BY-NC 4.0

Published Online: 03-02-2025

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim and background: The objective was to determine the reference intervals for free thyroxine (FT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) in singleton pregnant women residing in the South Coastal Karnataka. Materials and methods: This observational prospective cross-sectional study was conducted after obtaining ethics approval. A total of 360 singleton pregnant women (120 each in all the trimesters) were recruited from a tertiary care hospital, after obtaining written consent from the study participants. Blood samples were collected and serum levels of FT4, FT3, TSH, and anti-TPO were determined using an autoanalyzer, by electrochemiluminescence immunoassay. Using nonparametric tests, the reference intervals for FT4, FT3, TSH, and anti-TPO were calculated for each trimester. Results: This study showed a significant increase in the levels of TSH throughout the trimesters: 1.5 µIU/mL, 2.13 µIU/mL, and 2.77 µIU/mL and a notable decline in levels of FT4 and FT3 throughout the trimesters: From 1.3 (1.16, 1.4) ng/dL and 2.9 (2.7, 3.2) pg/mL in the first trimester to 1.0 (0.98, 1.2) ng/dL and 2.6 (2.3, 2.8) pg/mL in the second trimester, and further to 1.0 (0.9, 1.1) ng/dL and 2.6 (2.3, 2.9) pg/mL in the third trimester, respectively (p < 0.001). But anti-TPO did not show statistically significant differences. Conclusion: The reference intervals of thyroid profile shall provide local clinicians with valuable guidance for interpreting thyroid function tests in pregnant women residing in South Coastal Karnataka as reference intervals are mostly developed in Western countries by recruiting their residents which may not be suitable for our population. Further research is warranted to validate these reference intervals in larger and more diverse populations and to explore their clinical implications in pregnancy care. Clinical significance: This research sets forth trimester-specific biological reference intervals for thyroid profiles tailored to the Coastal Karnataka population. These defined intervals serve to facilitate accurate diagnosis and mitigate the risk of either over-treatment or underdiagnosis of thyroid disorders during pregnancy.

PDF Share
  1. Tal R, Taylor HS. Endocrinology of pregnancy. [Updated 2021 Mar 18]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
  2. Brunton PJ, Russell JA. Neuroendocrine control of maternal stress responses and fetal programming by stress in pregnancy. Prog Neuropsychopharmacol Biol Psychiatry 2011;35(5):1178–1191. DOI: 10.1016/j.pnpbp.2010.12.023.
  3. Mullur R, Liu YY, Brent GA. Thyroid hormone regulation of metabolism. Physiol Rev 2014;94(2):355–382. DOI: 10.1152/physrev.00030.2013.
  4. Cicatiello AG, Di Girolamo D, Dentice M. Metabolic effects of the intracellular regulation of thyroid hormone: Old players, new concepts. Frontiers in Endocrinol 2018;9:404729. DOI: 10.3389/fendo.2018.00474.
  5. Mégier C, Dumery G, Luton D. Iodine and thyroid maternal and fetal metabolism during pregnancy. Metabolites 2023;13(5):633. DOI: 10.3390/metabo13050633.
  6. Thorpe-Beeston JG, Nicolaides KH, Felton CV, et al. Maturation of the secretion of thyroid hormone and thyroid-stimulating hormone in the fetus. New Engl J Med 1991;324(8):532–536. DOI: 10.1056/NEJM199102213240805.
  7. Visser WE, Peeters RP. Interpretation of thyroid function tests during pregnancy. Best Pract Res Clin Endocrinol Metab 2020;34(4):101431. DOI: 10.1016/j.beem.2020.101431.
  8. Alexander Erik K, Pearce Elizabeth N, Brent Gregory A, et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 2017;27(3):315–389. DOI: 10.1089/thy.2016.0457.correx.
  9. Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011;21(10):1081–1125. DOI: 10.1089/thy.2011.0087.
  10. De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: An Endocrine Society clinical practice guideline. The J Clin Endocrinol Metab 2012;97(8):2543–2565. DOI: 10.1210/jc.2011-2803.
  11. Yan YQ, Dong ZL, Dong L, et al. Trimester-and method-specific reference intervals for thyroid tests in pregnant Chinese women: Methodology, euthyroid definition and iodine status can influence the setting of reference intervals. Clinical Endocrinol 2011;74(2):262–269. DOI: 10.1111/j.1365-2265.2010.03910.x.
  12. Li C, Shan Z, Mao J, et al. Assessment of thyroid function during first-trimester pregnancy: What is the rational upper limit of serum TSH during the first trimester in Chinese pregnant women? J Clin Endocrinol Metab 2014;99(1):73–79. DOI: 10.1210/jc.2013-1674.
  13. Marwaha RK, Chopra S, Gopalakrishnan S, et al. Establishment of reference range for thyroid hormones in normal pregnant Indian women. BJOG: Int J Obstet Gynaecol 2008;115(5):602–606. DOI: 10.1111/j.1471-0528.2008.01673.x.
  14. Moon HW, Chung HJ, Park CM, et al. Establishment of trimester-specific reference intervals for thyroid hormones in Korean pregnant women. Ann Lab Med 2015;35(2):198. DOI: 10.3343/alm.2015.35.2.198.
  15. Kim HH, Hong HS, Kim SY, et al. An improved auto-generation system to obtain reference intervals for laboratory medicine. Healthc Inform Res 2010;16(1):15–21. DOI: 10.4258/hir.2010.16.1.15.
  16. Linnet K. Two-stage transformation systems for normalization of reference distributions evaluated. Clin Chem 1987;33(3):381–386. PMID: 815802.
  17. Reed AH, Henry RJ, Mason WB. Influence of statistical method used on the resulting estimate of normal range. Clin Chem 1971;17(4):275–284. PMID: 5552364.
  18. Geno KA, Nerenz RD. Evaluating thyroid function in pregnant women. Crit Rev Clin Lab Sci 2022;59(7):460–479. DOI: 10.1080/10408363.2022.2050182.
  19. Gronowski AM. Evaluation of thyroid function during pregnancy: Have we taken a wrong turn? Clin Chem 2018;64(3):439–441. DOI: 10.1373/clinchem.2017.281261.
  20. Oblak A, Biček A, Pirnat E, et al. First estimation of reference intervals for thyroid-stimulating hormone and thyroid hormones in slovenian population. Acta Chim Slov 2021;68:488–493. PMID: 34738129.
  21. Zhang D, Cai K, Wang G, et al. Trimester-specific reference ranges for thyroid hormones in pregnant women 2019;98(4):e14245. DOI: 10.1097/MD.0000000000014245.
  22. Pramanik S, Mukhopadhyay P, Bhattacharjee K, et al. Trimester-specific reference intervals for thyroid function parameters in Indian pregnant women during final phase of transition to iodine sufficiency. Indian J Endocrinol Metab 2020;24(2):160–164. DOI: 10.4103/ijem.IJEM_561_19.
  23. Patel A, Gajjar M, Gajjar D. Establishment of reference range for maternal thyroid function of Gujarati women. MedPulse Int J Biochem 2019;2(2):47–51. DOI: 10.26611/10021223.
  24. Rani KS, Tirupati S, Sarathi V, et al. Trimester-specific reference ranges for thyroid function tests in South Indian women. Thyroid Res Pract 2018;15(3):117–121. DOI: 10.4103/trp.trp_24_18.
  25. Kalra S, Agarwal S, Aggarwal R, et al. Trimester-specific thyroid-stimulating hormone: An Indian perspective. Indian J Endocrinol Metab 2018;22(1):1–4. DOI: 10.4103/ijem.IJEM_107_17.
  26. Khadilkar S. Thyroid-stimulating hormone values in pregnancy: Cutoff controversy continues? J Obstet Gynaecol India 2019;69:389–394. DOI: 10.1007/s13224-019-01272-w.
  27. Smals AGH, Ross HA, Kloppenborg PWC. Seasonal variation in serum T3 and T4 levels in man. J Clin Endocrinol Metab 1977;44:998. DOI: 10.1210/jcem-44-5-998.
  28. DuRuisseau JP. Seasonal variation of PBI in healthy Montrealers. J Clin Endocrinol Metab 1965;25:1513. DOI: 10.1210/jcem-25-11-1513.
  29. Reed HL. Environmental influences on thyroid hormone regulation. in Werner and Ingbar's The Thyroid, 7th Edition. Braverman LE, Utiger RD (eds). Philadelphia: JB Lippincot; 1996. pp. 259–265.
  30. Rastogi GK, Malhotra MS, Srivastava MC, et al. Study of the pituitary-thyroid functions at high altitude in man. J Clin Endocrinol Metab 1977;44(3):447–452. DOI: 10.1210/jcem-44-3-447.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.