Abstract | CONTEXT: OBJECTIVE: The study correlated fetal free T(4) (fT4) with fetal ultrasound parameters and maternal thyroid function, thyroid antibodies, and medication dose from mothers with AITD. DESIGN AND SETTING: The study was designed as a prospective cohort study and conducted in an academic referral center. PATIENTS: MAIN OUTCOME MEASURES: Outcomes were as follows: 1) fetal-fT4, TSH, ultrasound parameters (morphology, biometrics, heart rate); and 2) maternal-fT4, TSH, antithyroid drug dose, and antithyroid antibodies, thyroid peroxidase and TSH receptor (TRAK). Parameters were determined at the same time, between the 22nd and 33rd wk gestation. RESULTS: A total of 48.3% of fetuses from hyperthyroid mothers, 60% of fetuses from hypothyroid mothers, and 10% of fetuses from euthyroid mothers had elevated fT4 levels (P = 0.006). In hypothyroid mothers, the presence of both thyroid antibodies was related to fetal hyperthyroidism, whereas absence was related to fetal euthyroidism (P = 0.019). Hyperthyroid mothers (TRAK-positive, thyroid peroxidase-negative) with hyperthyroid fetuses had significantly higher mean TRAK than hyperthyroid mothers with euthyroid fetuses (13.7 vs. 3.7 IU/liter; P = 0.02). Fetal fT4 correlated weakly negatively with maternal TSH within the normal range, but not with ultrasound parameters or with antithyroid drug dose. CONCLUSION: High fetal fT4 levels were unexpectedly frequent in women with AITD, including maternal autoimmune hypo- and hyperthyroidism. Further studies are needed, as well as noninvasive methods to assess fetal thyroid function.
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Authors | Svetlana Spremovic-Radjenovic, Aleksandra Gudovic, Gordana Lazovic, Jelena Marinkovic, Nebojsa Radunovic, Aleksandar Ljubic |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 97
Issue 11
Pg. 4014-21
(Nov 2012)
ISSN: 1945-7197 [Electronic] United States |
PMID | 22948761
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Autoimmune Diseases
(blood, drug therapy)
- Female
- Fetal Blood
- Humans
- Hyperthyroidism
(blood, drug therapy)
- Hypothyroidism
(blood, drug therapy)
- Pregnancy
- Pregnancy Complications
(blood, drug therapy, immunology)
- Prospective Studies
- Thyroid Function Tests
- Thyrotropin
(blood)
- Thyroxine
(blood)
- Ultrasonography, Prenatal
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