Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism

Spyridoula Maraka, Naykky M. Singh Ospina, Derek T. O'Keeffe, Rene Rodriguez-Gutierrez, Ana E. Espinosa De Ycaza, Chung Il Wi, Young J Juhn, Charles C. Coddington, Victor Manuel Montori, Marius N. Stan

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Subclinical hypothyroidism (SCH) has been associated with increased risk of adverse pregnancy outcomes in some, but not all, studies. Uncertainty remains regarding the impact of levothyroxine (LT4) therapy on improving health outcomes in pregnant women with SCH. The objective of this study was to assess the potential benefits of LT4 therapy in pregnant women with SCH. Methods: The medical records were reviewed of pregnant women with SCH, defined as an elevated serum thyrotropin (TSH) of >2.5 mIU/L for the 1st trimester or >3 mIU/L for the 2nd and 3rd trimesters, but ≤10 mIU/L. Pregnant women were divided into two groups depending on whether they received LT4 (group A) or not (group B). Pregnancy loss and other pre-specified adverse outcomes were evaluated during follow-up. Results: There were 82 women in group A and 284 in group B. Group A had a higher body mass index (p = 0.04) and a higher serum TSH level (p <0.0001) compared with group B. Group A had fewer pregnancies lost (n = 5 [6.1%] vs. n = 25 [8.8%]; p = 0.12), low birth weight (LBW) offspring (1.3% vs. 10%; p <0.001), and no neonates with a five-minute Apgar score ≤7 (0% vs. 7%; p <0.001) compared with group B. Other pregnancy-related adverse outcomes were similar between the two groups. Inferences remained unchanged after considering different models to adjust for potential predictors of outcome. Conclusions: LT4 therapy is associated with a decreased risk of LBW and a low Apgar score among women with SCH. This association awaits confirmation in randomized trials before the widespread use of LT4 therapy in pregnant women with SCH.

Original languageEnglish (US)
Pages (from-to)980-986
Number of pages7
JournalThyroid
Volume26
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Pregnancy Outcome
Hypothyroidism
Thyroxine
Pregnant Women
Apgar Score
Low Birth Weight Infant
Pregnancy
Therapeutics
Thyrotropin
Serum
Uncertainty
Medical Records
Body Mass Index
Newborn Infant
Health

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Maraka, S., Singh Ospina, N. M., O'Keeffe, D. T., Rodriguez-Gutierrez, R., Espinosa De Ycaza, A. E., Wi, C. I., ... Stan, M. N. (2016). Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism. Thyroid, 26(7), 980-986. https://doi.org/10.1089/thy.2016.0014

Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism. / Maraka, Spyridoula; Singh Ospina, Naykky M.; O'Keeffe, Derek T.; Rodriguez-Gutierrez, Rene; Espinosa De Ycaza, Ana E.; Wi, Chung Il; Juhn, Young J; Coddington, Charles C.; Montori, Victor Manuel; Stan, Marius N.

In: Thyroid, Vol. 26, No. 7, 01.07.2016, p. 980-986.

Research output: Contribution to journalArticle

Maraka, S, Singh Ospina, NM, O'Keeffe, DT, Rodriguez-Gutierrez, R, Espinosa De Ycaza, AE, Wi, CI, Juhn, YJ, Coddington, CC, Montori, VM & Stan, MN 2016, 'Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism', Thyroid, vol. 26, no. 7, pp. 980-986. https://doi.org/10.1089/thy.2016.0014
Maraka S, Singh Ospina NM, O'Keeffe DT, Rodriguez-Gutierrez R, Espinosa De Ycaza AE, Wi CI et al. Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism. Thyroid. 2016 Jul 1;26(7):980-986. https://doi.org/10.1089/thy.2016.0014
Maraka, Spyridoula ; Singh Ospina, Naykky M. ; O'Keeffe, Derek T. ; Rodriguez-Gutierrez, Rene ; Espinosa De Ycaza, Ana E. ; Wi, Chung Il ; Juhn, Young J ; Coddington, Charles C. ; Montori, Victor Manuel ; Stan, Marius N. / Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism. In: Thyroid. 2016 ; Vol. 26, No. 7. pp. 980-986.
@article{9bcaa8a4b4bb4366b5e507582cfc5d3d,
title = "Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism",
abstract = "Background: Subclinical hypothyroidism (SCH) has been associated with increased risk of adverse pregnancy outcomes in some, but not all, studies. Uncertainty remains regarding the impact of levothyroxine (LT4) therapy on improving health outcomes in pregnant women with SCH. The objective of this study was to assess the potential benefits of LT4 therapy in pregnant women with SCH. Methods: The medical records were reviewed of pregnant women with SCH, defined as an elevated serum thyrotropin (TSH) of >2.5 mIU/L for the 1st trimester or >3 mIU/L for the 2nd and 3rd trimesters, but ≤10 mIU/L. Pregnant women were divided into two groups depending on whether they received LT4 (group A) or not (group B). Pregnancy loss and other pre-specified adverse outcomes were evaluated during follow-up. Results: There were 82 women in group A and 284 in group B. Group A had a higher body mass index (p = 0.04) and a higher serum TSH level (p <0.0001) compared with group B. Group A had fewer pregnancies lost (n = 5 [6.1{\%}] vs. n = 25 [8.8{\%}]; p = 0.12), low birth weight (LBW) offspring (1.3{\%} vs. 10{\%}; p <0.001), and no neonates with a five-minute Apgar score ≤7 (0{\%} vs. 7{\%}; p <0.001) compared with group B. Other pregnancy-related adverse outcomes were similar between the two groups. Inferences remained unchanged after considering different models to adjust for potential predictors of outcome. Conclusions: LT4 therapy is associated with a decreased risk of LBW and a low Apgar score among women with SCH. This association awaits confirmation in randomized trials before the widespread use of LT4 therapy in pregnant women with SCH.",
author = "Spyridoula Maraka and {Singh Ospina}, {Naykky M.} and O'Keeffe, {Derek T.} and Rene Rodriguez-Gutierrez and {Espinosa De Ycaza}, {Ana E.} and Wi, {Chung Il} and Juhn, {Young J} and Coddington, {Charles C.} and Montori, {Victor Manuel} and Stan, {Marius N.}",
year = "2016",
month = "7",
day = "1",
doi = "10.1089/thy.2016.0014",
language = "English (US)",
volume = "26",
pages = "980--986",
journal = "Thyroid",
issn = "1050-7256",
publisher = "Mary Ann Liebert Inc.",
number = "7",

}

TY - JOUR

T1 - Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism

AU - Maraka, Spyridoula

AU - Singh Ospina, Naykky M.

AU - O'Keeffe, Derek T.

AU - Rodriguez-Gutierrez, Rene

AU - Espinosa De Ycaza, Ana E.

AU - Wi, Chung Il

AU - Juhn, Young J

AU - Coddington, Charles C.

AU - Montori, Victor Manuel

AU - Stan, Marius N.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: Subclinical hypothyroidism (SCH) has been associated with increased risk of adverse pregnancy outcomes in some, but not all, studies. Uncertainty remains regarding the impact of levothyroxine (LT4) therapy on improving health outcomes in pregnant women with SCH. The objective of this study was to assess the potential benefits of LT4 therapy in pregnant women with SCH. Methods: The medical records were reviewed of pregnant women with SCH, defined as an elevated serum thyrotropin (TSH) of >2.5 mIU/L for the 1st trimester or >3 mIU/L for the 2nd and 3rd trimesters, but ≤10 mIU/L. Pregnant women were divided into two groups depending on whether they received LT4 (group A) or not (group B). Pregnancy loss and other pre-specified adverse outcomes were evaluated during follow-up. Results: There were 82 women in group A and 284 in group B. Group A had a higher body mass index (p = 0.04) and a higher serum TSH level (p <0.0001) compared with group B. Group A had fewer pregnancies lost (n = 5 [6.1%] vs. n = 25 [8.8%]; p = 0.12), low birth weight (LBW) offspring (1.3% vs. 10%; p <0.001), and no neonates with a five-minute Apgar score ≤7 (0% vs. 7%; p <0.001) compared with group B. Other pregnancy-related adverse outcomes were similar between the two groups. Inferences remained unchanged after considering different models to adjust for potential predictors of outcome. Conclusions: LT4 therapy is associated with a decreased risk of LBW and a low Apgar score among women with SCH. This association awaits confirmation in randomized trials before the widespread use of LT4 therapy in pregnant women with SCH.

AB - Background: Subclinical hypothyroidism (SCH) has been associated with increased risk of adverse pregnancy outcomes in some, but not all, studies. Uncertainty remains regarding the impact of levothyroxine (LT4) therapy on improving health outcomes in pregnant women with SCH. The objective of this study was to assess the potential benefits of LT4 therapy in pregnant women with SCH. Methods: The medical records were reviewed of pregnant women with SCH, defined as an elevated serum thyrotropin (TSH) of >2.5 mIU/L for the 1st trimester or >3 mIU/L for the 2nd and 3rd trimesters, but ≤10 mIU/L. Pregnant women were divided into two groups depending on whether they received LT4 (group A) or not (group B). Pregnancy loss and other pre-specified adverse outcomes were evaluated during follow-up. Results: There were 82 women in group A and 284 in group B. Group A had a higher body mass index (p = 0.04) and a higher serum TSH level (p <0.0001) compared with group B. Group A had fewer pregnancies lost (n = 5 [6.1%] vs. n = 25 [8.8%]; p = 0.12), low birth weight (LBW) offspring (1.3% vs. 10%; p <0.001), and no neonates with a five-minute Apgar score ≤7 (0% vs. 7%; p <0.001) compared with group B. Other pregnancy-related adverse outcomes were similar between the two groups. Inferences remained unchanged after considering different models to adjust for potential predictors of outcome. Conclusions: LT4 therapy is associated with a decreased risk of LBW and a low Apgar score among women with SCH. This association awaits confirmation in randomized trials before the widespread use of LT4 therapy in pregnant women with SCH.

UR - http://www.scopus.com/inward/record.url?scp=84978394445&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978394445&partnerID=8YFLogxK

U2 - 10.1089/thy.2016.0014

DO - 10.1089/thy.2016.0014

M3 - Article

C2 - 27112035

AN - SCOPUS:84978394445

VL - 26

SP - 980

EP - 986

JO - Thyroid

JF - Thyroid

SN - 1050-7256

IS - 7

ER -