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Thyroid Hormone Treatment’s Impact on Pregnancy Loss

BMJ; ePub 2017 Jan 25; Maraka, Mwangi, et al

Thyroid hormone treatment led to decreased risk of pregnancy loss in women with subclinical hypothyroidism in a retrospective cohort study involving more than 5,400 pregnant women.

Participants had subclinical hypothyroidism, some with average thyroid stimulating hormone (TSH) concentration of 4.8 mIU/L who were treated with thyroid hormone (n=843), and others with average TSH concentration of 3.3 mIU/L who were not treated (n=4,562). Investigators looked at pregnancy loss and other maternal and fetal adverse outcomes. Among the results:

  • Pregnancy loss occurred in 11% of treated women, vs 15% in those untreated, a significant difference.
  • Untreated women were 38% less likely to experience pregnancy loss.
  • They were 60% more likely to have a preterm delivery, 37% more likely to develop gestational diabetes, and 61% more likely to experience pre-eclampsia.
  • Untreated women with pre-treatment THS levels of 4.1 to 10 mIU/L were 55% less likely to experience pregnancy loss, compared with treated women.
  • This was not seen when pre-treatment TSH levels were 2.5 to 4.0 mIU/L in untreated women.

Citation:

Maraka S, Mwangi R, McCoy R, et al. Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment. [Published online ahead of print January 25, 2017]. BMJ. doi:10.1136/bmj.i6865.

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