Longitudinal trajectories of maternal TSH in healthy pregnant women in Catalonia.

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2023-08-11 DOI:10.1530/ETJ-23-0016
Berta Soldevila, Inés Velasco, Carla Muñoz, Yesika Díaz, Laia Egea-Cortés, Laura Ferrer-Escopiñan, Alejandra Pérez-Montes de Oca, Raquel Martínez-Mondejar, Jordi Casabona, Manel Puig-Domingo
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Abstract

Objective: Longitudinal evaluation of thyroid function throughout pregnancy in the same subject could offer precise information about its dynamics as a physiological mechanism of adaption to the requirements. In this study, we evaluated longitudinal trajectories of maternal thyroid function during pregnancy by a latent class growth analysis and explored their association with maternal-fetal outcomes.

Methods: A prospective observational study was carried out, including 414 healthy pregnant women, from the first trimester to delivery. Thyroid function and autoimmunity were measured in the three trimesters. Clinical data during pregnancy were obtained. Longitudinal mixed model techniques were performed to explore trajectories of gestational thyroid function.

Results: Three different longitudinal trajectories were obtained from maternal thyrotropin (TSH) levels: low-increasing TSH (class 1) in 86% of cases, high-increasing TSH (class 2) in 9.7%, and decreasing TSH (class 3) in 4.3%. No statistical differences in free thyroxine levels were found among the three classes. Differences in maternal age (P = 0.027) and initial maternal weight (P = 0.043) were observed among the groups. In logistic regression analysis, maternal age correlated with longitudinal trajectories. The three longitudinal classes remain when women with thyroid autoimmunity (TAI) are excluded. Multinomial logistic regression showed maternal age correlated with longitudinal trajectories independently of TAI status.

Conclusions: Three differentiated TSH trajectories were found in healthy pregnant women living in Catalonia, as previously described. No association with obstetric outcomes was observed in these different chronological thyroid pathways, but maternal age might condition the longitudinal mechanism of thyroid function regulation throughout pregnancy.

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在加泰罗尼亚健康孕妇母体TSH的纵向轨迹。
目的:对同一受试者在妊娠期间的甲状腺功能进行纵向评估,以提供其动态作为适应需求的生理机制的准确信息。在这项研究中,我们通过潜在类生长分析评估了怀孕期间母亲甲状腺功能的纵向轨迹,并探讨了它们与母胎结局的关系。方法:一项前瞻性观察研究,包括414名健康孕妇,从妊娠早期到分娩。在妊娠三个月检测甲状腺功能和自身免疫。获得妊娠期临床资料。采用纵向混合模型技术探索妊娠甲状腺功能的发展轨迹。结果:母体促甲状腺激素(TSH)水平有三种不同的纵向轨迹:86%的病例TSH低升高(1类),9.7%的病例TSH高升高(2类),4.3%的病例TSH降低(3类)。三组间游离甲状腺素水平无统计学差异。各组产妇年龄(P = 0.027)、初始体重(P = 0.043)差异均有统计学意义。在logistic回归分析中,母亲年龄与纵向轨迹相关。当排除甲状腺自身免疫(TAI)的妇女时,这三个纵向分类仍然存在。多项逻辑回归显示,母亲年龄与纵向轨迹相关,与TAI状态无关。结论:如前所述,在生活在加泰罗尼亚的健康孕妇中发现了三个不同的TSH轨迹。在这些不同的时间顺序甲状腺通路中没有观察到与产科结局的关联,但母亲年龄可能会影响整个妊娠期间甲状腺功能调节的纵向机制。
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来源期刊
European Thyroid Journal
European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.70
自引率
2.10%
发文量
156
期刊介绍: The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.
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