Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes

Polyxeni Karakosta, Dimitris Alegakis, Vaggelis Georgiou, Theano Roumeliotaki, Eleni Fthenou, Maria Vassilaki, Dimitrios Boumpas, Elias Castanas, Manolis Kogevinas, Leda Chatzi

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

Context: Maternal thyroid dysfunction, especially in early pregnancy, may lead to pregnancy complications and adverse birth outcomes. Few population-based prospective studies have evaluated these effects and results are discrepant. Objective: We examined the association of thyroid function and autoimmunity in early pregnancy with adverse pregnancy and birth outcomes. Setting and Participants: The study used data from the prospective mother-child cohort "Rhea" study in Crete, Greece. A total of 1170 women with singleton pregnancies participated in this analysis. Maternal serum samples in the first trimester of pregnancy were tested for thyroidhormones (TSH, free T4, and free T3) and thyroid antibodies (thyroid peroxidase antibody and thyroglobulin antibody). Multivariable log-Poisson regression models were used adjusting for confounders. Main Outcome Measures: Outcomes included gestational diabetes, gestational hypertension/preeclampsia, cesarean section, preterm delivery, low birth weight, and small-for-gestational-age neonates. Results: The combination of high TSH and thyroid autoimmunity in early pregnancy was associated with a 4-fold increased risk for gestational diabetes [relative risk (RR) 4.3, 95% confidence interval (CI) 2.1- 8.9)] and a 3-fold increased risk for low birth weight neonates (RR 3.1,95%CI 1.2- 8.0) after adjustment for several confounders. Women positive for thyroid antibodies without elevated TSH levels in early pregnancy were at high risk for spontaneous preterm delivery (RR 1.7, 95% CI 1.1-2.8), whereas the combined effect of high TSH and positive thyroid antibodies did not show an association with preterm birth. Conclusions: High TSH levels and thyroid autoimmunity in early pregnancy may detrimentally affect pregnancy and birth outcomes.

Original languageEnglish (US)
Pages (from-to)4464-4472
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume97
Issue number12
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

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Gestational Diabetes
Medical problems
Autoantibodies
Thyroid Gland
Parturition
Pregnancy
Antibodies
Autoimmunity
Greece
Mothers
Low Birth Weight Infant
Confidence Intervals
Pregnancy Outcome
Rheiformes
Iodide Peroxidase
Newborn Infant
Thyroglobulin
Pregnancy Induced Hypertension
Pregnancy Complications
Premature Birth

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. / Karakosta, Polyxeni; Alegakis, Dimitris; Georgiou, Vaggelis; Roumeliotaki, Theano; Fthenou, Eleni; Vassilaki, Maria; Boumpas, Dimitrios; Castanas, Elias; Kogevinas, Manolis; Chatzi, Leda.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 97, No. 12, 01.12.2012, p. 4464-4472.

Research output: Contribution to journalArticle

Karakosta, P, Alegakis, D, Georgiou, V, Roumeliotaki, T, Fthenou, E, Vassilaki, M, Boumpas, D, Castanas, E, Kogevinas, M & Chatzi, L 2012, 'Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes', Journal of Clinical Endocrinology and Metabolism, vol. 97, no. 12, pp. 4464-4472. https://doi.org/10.1210/jc.2012-2540
Karakosta, Polyxeni ; Alegakis, Dimitris ; Georgiou, Vaggelis ; Roumeliotaki, Theano ; Fthenou, Eleni ; Vassilaki, Maria ; Boumpas, Dimitrios ; Castanas, Elias ; Kogevinas, Manolis ; Chatzi, Leda. / Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. In: Journal of Clinical Endocrinology and Metabolism. 2012 ; Vol. 97, No. 12. pp. 4464-4472.
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AU - Karakosta, Polyxeni

AU - Alegakis, Dimitris

AU - Georgiou, Vaggelis

AU - Roumeliotaki, Theano

AU - Fthenou, Eleni

AU - Vassilaki, Maria

AU - Boumpas, Dimitrios

AU - Castanas, Elias

AU - Kogevinas, Manolis

AU - Chatzi, Leda

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N2 - Context: Maternal thyroid dysfunction, especially in early pregnancy, may lead to pregnancy complications and adverse birth outcomes. Few population-based prospective studies have evaluated these effects and results are discrepant. Objective: We examined the association of thyroid function and autoimmunity in early pregnancy with adverse pregnancy and birth outcomes. Setting and Participants: The study used data from the prospective mother-child cohort "Rhea" study in Crete, Greece. A total of 1170 women with singleton pregnancies participated in this analysis. Maternal serum samples in the first trimester of pregnancy were tested for thyroidhormones (TSH, free T4, and free T3) and thyroid antibodies (thyroid peroxidase antibody and thyroglobulin antibody). Multivariable log-Poisson regression models were used adjusting for confounders. Main Outcome Measures: Outcomes included gestational diabetes, gestational hypertension/preeclampsia, cesarean section, preterm delivery, low birth weight, and small-for-gestational-age neonates. Results: The combination of high TSH and thyroid autoimmunity in early pregnancy was associated with a 4-fold increased risk for gestational diabetes [relative risk (RR) 4.3, 95% confidence interval (CI) 2.1- 8.9)] and a 3-fold increased risk for low birth weight neonates (RR 3.1,95%CI 1.2- 8.0) after adjustment for several confounders. Women positive for thyroid antibodies without elevated TSH levels in early pregnancy were at high risk for spontaneous preterm delivery (RR 1.7, 95% CI 1.1-2.8), whereas the combined effect of high TSH and positive thyroid antibodies did not show an association with preterm birth. Conclusions: High TSH levels and thyroid autoimmunity in early pregnancy may detrimentally affect pregnancy and birth outcomes.

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