全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Thyroid Function in Pregnant Women from a West-African Population

DOI: 10.4236/ojmip.2018.81001, PP. 1-11

Keywords: Pregnancy, Thyroid Function, Hypothyroidism

Full-Text   Cite this paper   Add to My Lib

Abstract:

Thyroid dysfunction is frequent in pregnant women and is often associated with an increased risk of adverse maternal and fetal outcome. In the present work, thyroid function of pregnant women from Benin republic was studied. Two hundred forty (240) pregnant women, without thyroid disease history, have been included in the study. A blood sample was drawn for measurement of TSH, free T3 and free T4 serum levels. From the first to the third trimester, plasma levels of free T3 and free T4 decreased when plasma levels of TSH increased. Using recommendations of the 2011 American Thyroid Association (ATA) guidelines, thyroid dysfunction was observed in 24.17% of subjects. Hypothyroidism was present in 22.50% of subjects with 19.17% of subclinical hypothyroidism, 0.83% of overt hypothyroidism and 2.50% of hypothyroxinemia and hyperthyroidism was observed in 1.67% of subjects. An increase from 15.52% to 28.07% was observed in the frequency of hypothyroidism from the first to the third trimester of pregnancy. When an upper cut-off value of 4 mU/L was used for TSH, as recommended in the 2017 ATA guidelines, prevalence of thyroid disorders was 14.58% with 12.91% of hypothyroidism but no hypothyroidism was observed in women in the first trimester of pregnancy. A rise in hypothyroidism frequency was observed when pregnant women age increased. Hypothyroidism was very common in pregnant women in Benin. To allow accurate assessment of thyroid status in pregnant women in Benin, pregnancy specific range for plasma level of TSH and thyroid hormones should be established.

References

[1]  Glinoer, D. (1997) Regulation of Thyroid Function in Pregnancy: Pathways of Endocrine Adaptation from Physiology to Pathology. Endocrine Reviews 18, 404-433.
https://doi.org/10.1210/edrv.18.3.0300
[2]  Lazarus, J.H. (2010) Thyroid Function in Pregnancy. British Medical Bulletin, 97, 137-148.
https://doi.org/10.1093/bmb/ldq039
[3]  Casey, B.M., Dashe, J.S., Wells, C.E., McIntire, D.D., Byrd, W., Leveno, K.J. and Cunningham, F.G. (2005) Subclinical Hypothyroidism and Pregnancy Outcomes. Obstetrics & Gynecology, 105, 239-245.
https://doi.org/10.1097/01.AOG.0000152345.99421.22
[4]  Carney, L.A., Quinlan, J.D. and Mehta S. (2014) Thyroid Disease in Pregnancy. American Family Physician, 89, 273-278.
[5]  Blatt, A.J., Nakamoto, J.M. and Kaufman, H.W. (2012) National Status of Testing for Hypothyroidism during Pregnancy and Postpartum. The Journal of Clinical Endocrinology & Metabolism, 97, 777-784.
https://doi.org/10.1210/jc.2011-2038
[6]  Moreno-Reyes, R., Glinoer, D., Van Oyen, H. and Vandevijvere, S. (2013) High Prevalence of Thyroid Disorders in Pregnant Women in a Mildly Iodine-Deficient Country: A Population Based Study. The Journal of Clinical Endocrinology & Metabolism, 98, 3694-3701.
https://doi.org/10.1210/jc.2013-2149
[7]  Ajmani, S.N., Aggarwal, D., Bhatia, P., Sharma, M., Sarrabhai, V. and Paul, M. (2014) Prevalence of Overt and Subclinical Thyroid Dysfunction among Pregnant Women and Its Effect on Maternal and Fetal Outcome. The Journal of Obstetrics and Gynecology of India, 64, 105-110. https://doi.org/10.1007/s13224-013-0487-y
[8]  Ahmed, I.Z., Eid, Y.M., El Orabi, H. and Ibrahim, H.R. (2014) Comparison of Universal and Target Screening for Thyroid Dysfunction in Pregnant Egyptian Women. European Journal of Endocrinology, 171, 285-291.
https://doi.org/10.1530/EJE-14-0100
[9]  Allan, W.C., Haddow, J.E., Palomaki, G.E., Williams, J.R., Mitchell, M.L., Hermos, R.J., Faix, J.D. and Klein, R.Z. (2000) Maternal Thyroid Deficiency and Pregnancy Complications. Journal of Medical Screening, 7, 127-130.
https://doi.org/10.1136/jms.7.3.127
[10]  Budenhofer, B.K., Ditsch, N., Jeschke, U., Gärtner, R. and Toth, B. (2013) Thyroid (Dys-)function in Normal and Disturb Pregnancy. Archives of Gynecology and Obstetrics, 287, 1-7. https://doi.org/10.1007/s00404-012-2592-z
[11]  Tingi, E., Syed, A.A., Kyriacou, A., Mastorakos, G. and Kyriacou, A. (2016) Benign Thyroid Disease in Pregnancy: A State of the Art Review. Journal of Clinical and Translational Endocrinology, 6, 37-49.
https://doi.org/10.1016/j.jcte.2016.11.001
[12]  Amoussou-Guenou, K.M., Awede, B., Koukpemedji, L., Adehan, S.A., Adjidobe, O. and Gangnabakpo, C.I. (2011) Interest of Thyroglobulinemia Measurement in Patients with Goiter Living in Iodine Deficiency Area in Benin. Médecine Nucléaire, 35, 517-521.
https://doi.org/10.1016/j.mednuc.2011.07.003
[13]  Stagnaro-Green, A., Abalovich, M., Elexander, E., Azizi, F., Mestman, J., Negro, R., Nixon, A., Pearce, E.N., Soldin, O.P., Sullivan, S. and Wiersinga, W. (2011) Guideslines of the American Thyroid Association for the Diagnosis and the Management of Thyroid Disease during Pregnancy. Thyroid, 21, 1081-1125.
https://doi.org/10.1089/thy.2011.0087
[14]  Alexander, E.K., Pearce, E.N., Brent, G.A., Brown, R.S., Chen, H., Dosiou, C., Grobman, W.A., Laurberg, P., Lazarus, J.H., Mandel, S.J., Peeters, R.P. and Sullivan, S. (2017) Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. Thyroid, 27, 315-389.
https://doi.org/10.1089/thy.2016.0457
[15]  Vermiglio, F., Lo Presti, V.P., Castagna, M.G., Violi, M.A., Moleti, M., Finocchiaro, M.D., Mattina, F., Artemisia, A. and Trimarchi, F. (1999) Increased Risk of Maternal Thyroid Failure with Pregnancy Progression in an Iodine Deficient Area with Major Iodine Deficiency Disorders. Thyroid, 9, 19-24.
https://doi.org/10.1089/thy.1999.9.19
[16]  Elhaj, E.T., Adam, I., Ahmed, M.A. and Lutfi, M.F. (2016) Trimester-Specific Thyroid Hormone Reference Ranges in Sudanese Women. BMC Physiology, 16, 15.
https://doi.org/10.1186/s12899-016-0025-0
[17]  El-Bashir, J.M., Abbiyesuku, F.M., Aliyu, I.S., Randawa, A.J., Adamu, R., Adamu, S., Akuyam, S.A., Manu, M., Suleiman, H.M., Yusuf, R. and Mohammed, A. (2015) Prevalence of Gestational Thyroid Disorders in Zaria, North-Western Nigeria. Annals of Nigerian Medicine, 9, 51-55.
https://doi.org/10.4103/0331-3131.177949
[18]  La’ulu, S.L. and Roberts, W. (2007) Second-Trimester Reference Intervals for Thyroid Tests: The Role for Ethnicity. Clinical Chemistry, 53, 1658-1664.
https://doi.org/10.1373/clinchem.2007.089680
[19]  La’ulu, S.L. and Roberts, W. (2011) Ethnic Differences in First Trimester Thyroid Reference Intervals. Clinical Chemistry, 57, 913-915.
https://doi.org/10.1373/clinchem.2010.161240
[20]  Lazarus, J., Brown, R.S., Daumerie, C., Hubalewska-Dydejcryk, A., Negro, R. and Vaidya, B. (2014) 2014 European Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnant and in Children. European Thyroid Journal, 3, 76-94.
https://doi.org/10.1159/000362597
[21]  Li, C., Shan, Z., Mao, J., Wang, W., Xie, X., Zhou, W., Li, C., Xu, B., Meng, T., Du, J., Zhang, S., Gao, Z., Zhang, X., Yang, L., Fan, C. and Teng, W. (2014) Assessment of Thyroid Function during First-Trimester Pregnancy: What Is the Rational Upper Limit of Serum TSH during the First Trimester in Chinese Women? The Journal of Clinical Endocrinology & Metabolism, 99, 73-79. https://doi.org/10.1210/jc.2013-1674
[22]  Xing, J., Yuan, E., Li, J., Zhang, Y., Meng, X., Zhang, X., Rong, S., Lv, Z., Tian, Y. and Jia, L. (2016) Trimester- and Assay-Specific Thyroid Reference Intervals for Pregnant Women in China. International Journal of Endocrinology, 2016, Article ID: 3754213.
[23]  Rajput, R., Singh, B., Goel, V., Verma, A., Seth, S. and Nanda, S. (2016) Trimester Specific Reference Interval for Thyroid Hormones during Pregnancy at a Tertiary Care Hospital in Haryana, India. Indian Journal of Endocrinology and Metabolism, 20, 810-815.
https://doi.org/10.4103/2230-8210.192903
[24]  Vejbjerg, P., Knudsen, N., Perrild, H., Laurberg, P., Carlé, A., Pedersen, I.B., Rasmussen, L.B., Ovesen, L. and Jørgensen, T. (2009) Thyroglubulin as a Marker of Iodine Nutrition Status in the General Population. European Journal of Endocrinology, 161, 475-481.
https://doi.org/10.1530/EJE-09-0262
[25]  Zimmermann, M.B., Aeberli, I., Andersson, M., Assey, V., Yorg, J.A., Jooste, P., Jukic, T., Kartono, D., Kusic, Z., Pretell, E., San Luis Jr., T.O., Untoro, J. and Timmer, A. (2013) Thyroglobulin Is a Sensitive Measure of Both Deficient and Excess Iodine Intakes in Children and Indicates No Adverse Effects on Thyroid Function in the UIC Range of 100-299 μg/L: A UNICEF/ICCIDD Study Group Report. The Journal of Clinical Endocrinology & Metabolism, 98, 1271-1280.
https://doi.org/10.1210/jc.2012-3952
[26]  Nazarpour, S., Terhani, F.R., Simbar, M., Tohidi, M., AlaviMajd, H. and Azizi, F. (2016) Comparison of Universal Screening with Harget High-Risk Case Finding for Diagnosis of Thyroid Disorders. European Journal of Endocrinology, 174, 77-83.
https://doi.org/10.1530/EJE-15-0750

Full-Text

comments powered by Disqus

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133

WeChat 1538708413