FREQUENCY OF ISOLATED MATERNAL HYPOTHYROXINEMIA AT PREGNANCY AND ASSESSMENT OF FETAL – MATERNAL EFFECTS

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 498-531-Female Repro Endocrinology & Case Reports
Clinical
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-517
Gulhan Akbaba*1, Eren Akbaba2, Dilek Berker1, Serhat Isik1, Bercem Aycicek Dogan1, Yasemin Tutuncu1, Nuri Danisman3 and Serdar Guler4
1Ankara Numune Training and Research Hospital, Ankara, Turkey, 2Mugla Sitki Kocman University Faculty of Medicine, mugla, Turkey, 3Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, Ankara, Turkey, 4Hitit University Faculty of Medicine, Corum, Turkey
Aim: It is not easy to find out the real incidence of isolated maternal hypothyroxinemia as there aren’t any precisely defined criteria for diagnosis. In light of our knowledge there isn’t any study that was conducted about the prevalence of IH, thus we planned this study aiming to find out the IH prevalence in our region and the maternal – fetal effects of IH.

Material and Method: 196 pregnant who are older than 18 years old without previous thyroidal disease and having singleton live pregnancy that the pregnancy became spontaneously at the 4 – 12th pregnancy week that are applied to the Obstetrics and Gynecology policlinics for the first routine obstetric control are included in the study. 6 pregnant women didn’t complete the study due to the abortus in the first trimester. All of these cases were euthyroid. Hypothyroidea is detected at three and hyperthyroidea is detected at 2 pregnant women and they are excluded from the study. From all of the remaining 185 pregnant women, free (fT3), free (fT4), thyroid stimulating hormone (TSH), anti-thyroid peroxidase antibody (TPO-Ab) and antithyroglobuline antibody (TG-Ab) and urinay iodine measures ar done at each of the three trimesters.

Results: Mean age was 25.7 ± 5.2 years (20-41), baseline measurements were for fT3: 3.28 ± 0.37 pg/mL, for fT4: 0.91 ± 0.14 ng/dL, for TSH median: 0.81 (1.03) (µIU/ml),  and for urinary iodine: 117.50 (64.50) µg/dl. Of the 185 pregnant women IH is detected at 72 (38%) of them. When the assessment was done for each trimester; there wasn’t any patient that the IH is detected, at the 2nd trimester 59/185 (32%) and at the 3rd trimester 50/185 (27%) pregnant were detected to have IH. While the 13 (26%) of the patients detected at the last trimester were new onset IH, at the 37 (74%) of the patients IH was present even at the 2nd trimester. Treatment wasn’t administered to the patients who were detected to have isolate hypothyroxinemia. No significant difference is detected between the patients at whom isolated hypothyroxinemia was detected and those it wasn’t detected in terms of age, weight and pregnancy week (p<0.05). First trimester TPO-Ab (respectively 4.4±18.02 vs 14.3±74.8, p=0.494), urinary iodine (respectively 125.4±40.5 vs   137.6±66.6, p=0.377), and section rates (respectively 44.4% vs  37.1%, p= 0.400) were same. Any relationship between the fT4 levels at the first and 2nd trimesters and way of birth, birth weight and presence of complications. While any statistically significant relationship between the free T4 levels of the patients measured at the third trimester and the way of birth or presence of complications (p values respectively 0.653 and 1.000); the birth weights of the children of the patients who have IH at the third trimester are found to be heavier (3200 vs 3600) (p=0.029).

Conclusion: Any negative effect on fetal development and obstetric outcomes is not observed at the patients with isolated hypothyroxinemia.

Nothing to Disclose: GA, EA, DB, SI, BAD, YT, ND, SG

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm