Abstract
References
- Bilici G, Ural C, Saçik U, Çavdar Z, Erbil G. The effects of hypothyroidism and hyperthyroidism on placental Hofbauer cells of pregnant rats. Biotech Histochem. 2022;97(2):126-135.
- Dündar İ, Akıncı A. The Frequency of Subclinical hypothyroidism in obese children and adolescents and its relationship with metabolic parameters and atherogenic index. Turk Arch Pediatr. 2022;57(3):316-322.
- Karcaaltincaba D, Ozek MA, Ocal N, Calis P, Inan MA, Bayram M. Prevalences of subclinical and overt hypothyroidism with universal screening in early pregnancy. Arch Gynecol Obstet. 2020;301(3):681-686.
- Korkut S, Çaylan N, Özgü-Erdinç AS, et al. Effect of maternal subclinical hypothyroidism on congenital hypothyroidism screening results: a retrospective cohort study. Am J Perinatol. 2022;10.1055/a-1819-1669.
- Kut A, Gursoy A, Senbayram S, Bayraktar N, Budakoğlu, II, Akgün HS. Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey. J Endocrinol Invest. 2010;33(7):461-464.
- Bulmus N, Ustuner I, Seda Guvendag Guven E, Kir Sahin F, Senturk S, Baydur Sahin S. Thyroid diseases in pregnancy: the importance of anamnesis. Pak J Med Sci. 2013;29(5):1187-1192.
- Karpuzoglu H, Ucal Y, Kumru P, et al. Increased maternal leptin levels may be an indicator of subclinical hypothyroidism in a newborn. J Med Biochem. 2022;41(2):156-161.
- Teziç T, Gedik Y. Serum thyrotropin, thyroxin and triiodothyronine concentrations in maternal and cord blood of goitrous and non-goitrous pregnant women living in the Black Sea Region of Turkey. Turk J Pediatr. 1988;30(3):153-158.
- Tosun G, Kose S, İşbilen Başok B, Altunyurt S. First-trimester placental function in levothyroxine-using pregnant women: a case-control study. Gynecol Endocrinol. 2020;36(3):233-237.
- Toloza FJK, Abedzadeh-Anaraki S, Maraka S. Subclinical hypothyroidism in pregnancy. Curr Opin Endocrinol Diabetes Obes. 2019;26(5):225-231.
- Maraka S, Ospina NM, O'Keeffe DT, et al. Subclinical hypothyroidism in pregnancy: a systematic review and meta-analysis. Thyroid. 2016;26(4):580-590.
- Kurek Eken M, Tüten A, Ozkaya E, et al. Evaluation of the maternal and fetal risk factors associated with neonatal care unit hospitalization time. J Matern Fetal Neonatal Med. 2016;29(21): 3553-3557.
- Tranquilli AL, Landi B, Giannubilo SR, Sibai BM. Preeclampsia: No longer solely a pregnancy disease. Pregnancy Hypertens. 2012;2(4):350-357.
- Stagnaro-Green A. Overt hyperthyroidism and hypothyroidism during pregnancy. Clin Obstet Gynecol. 2011;54(3):478-487.
- Wang YF, Yang HX. [Clinical analysis of hypothyroidism during pregnancy]. Zhonghua Fu Chan Ke Za Zhi. 2007;42(3):157-160.
- Li X, Zhang W, Lin J, et al. Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases. J Clin Hypertens (Greenwich). 2018;20(6):1049-1057.
- Zhang Y, Dai X, Yang S, et al. Maternal low thyroxin levels are associated with adverse pregnancy outcomes in a Chinese population. PLoS One. 2017;12(5):e0178100.
- Gietka-Czernel M, Glinicki P. Subclinical hypothyroidism in pregnancy: controversies on diagnosis and treatment. Pol Arch Intern Med. 2021;131(3):266-275.
- Busnelli A, Vannucchi G, Paffoni A, et al. Levothyroxine dose adjustment in hypothyroid women achieving pregnancy through IVF. Eur J Endocrinol. Oct 2015;173(4):417-424.
- Kashi Z, Bahar A, Akha O, Hassanzade S, Esmaeilisaraji L, Hamzehgardeshi Z. Levothyroxine dosage requirement during pregnancy in well-controlled hypothyroid women: a longitudinal study. Glob J Health Sci. 2015;8(4):227-233.
- Su X, Liu Y, Li G, et al. Associations of hypothyroxinemia with risk of preeclampsia–eclampsia and gestational hypertension. original research. Front Endocrinol. 2021;12
- Wang J, Gong XH, Peng T, Wu JN. Association of thyroid function during pregnancy with the risk of pre-eclampsia and gestational diabetes mellitus. Endocr Pract. 2021;27(8):819-825.
- Maraka S, Singh Ospina NM, O'Keeffe DT, et al. Effects of levothyroxine therapy on pregnancy outcomes in women with subclinical hypothyroidism. Thyroid. 2016;26(7):980-986.
- Jiao X-F, Zhang M, Chen J, et al. The impact of levothyroxine therapy on the pregnancy, neonatal and childhood outcomes of subclinical hypothyroidism during pregnancy: an updated systematic review, meta-analysis and trial sequential analysis. systematic review. Front Endocrinol. 2022;2022:13.
The impact of hypothyroidism and levothyroxine treatment on preeclampsia risk: unraveling the connection for improved maternal and neonatal outcomes
Abstract
Aims: Preeclampsia, a pregnancy-related complication, may develop in women with hypothyroidism. Possible risk factors may include comorbidities, predisposition to diabetes, obesity, advanced maternal age, and prior infertility treatments. The study aims to investigate the relationship between hypothyroidism and the risk of preeclampsia in pregnant women receiving levothyroxine by examining its application period.
Methods: This is a retrospective cohort included pregnant women who gave birth between December 2022-April 2023. Women with 110 preeclampsia and those without preeclampsia (152 controls) were identified and compared in terms of hypothyroidism status, type of hypothyroidism, and levothyroxine treatment.
Results: The results showed a significant association between the severity of the preeclampsia and its onset that early onset cases were more likely to be severe, while late onset cases were predominantly mild (p<0.001). The results showed no association between the onset of the preeclampsia and the starting treatment period (p=0.372). In the binary logistic regression, only one variable, "Apgar 5th minute" was significant in the logistic regression analysis (p=0.032). The coefficient indicates that as the "Apgar 5th minute” score increases, "during pregnancy" decrease by a factor of 0.603 (ODDs ratio; ranged from 0.380 to 0.957).
Conclusion: There was a difference in the distribution of mild and severe preeclampsia between
the euthyroid and hypothyroidism. Early threating hypothyroid with Levothyroxine might affect the Apgar score.
Keywords
References
- Bilici G, Ural C, Saçik U, Çavdar Z, Erbil G. The effects of hypothyroidism and hyperthyroidism on placental Hofbauer cells of pregnant rats. Biotech Histochem. 2022;97(2):126-135.
- Dündar İ, Akıncı A. The Frequency of Subclinical hypothyroidism in obese children and adolescents and its relationship with metabolic parameters and atherogenic index. Turk Arch Pediatr. 2022;57(3):316-322.
- Karcaaltincaba D, Ozek MA, Ocal N, Calis P, Inan MA, Bayram M. Prevalences of subclinical and overt hypothyroidism with universal screening in early pregnancy. Arch Gynecol Obstet. 2020;301(3):681-686.
- Korkut S, Çaylan N, Özgü-Erdinç AS, et al. Effect of maternal subclinical hypothyroidism on congenital hypothyroidism screening results: a retrospective cohort study. Am J Perinatol. 2022;10.1055/a-1819-1669.
- Kut A, Gursoy A, Senbayram S, Bayraktar N, Budakoğlu, II, Akgün HS. Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey. J Endocrinol Invest. 2010;33(7):461-464.
- Bulmus N, Ustuner I, Seda Guvendag Guven E, Kir Sahin F, Senturk S, Baydur Sahin S. Thyroid diseases in pregnancy: the importance of anamnesis. Pak J Med Sci. 2013;29(5):1187-1192.
- Karpuzoglu H, Ucal Y, Kumru P, et al. Increased maternal leptin levels may be an indicator of subclinical hypothyroidism in a newborn. J Med Biochem. 2022;41(2):156-161.
- Teziç T, Gedik Y. Serum thyrotropin, thyroxin and triiodothyronine concentrations in maternal and cord blood of goitrous and non-goitrous pregnant women living in the Black Sea Region of Turkey. Turk J Pediatr. 1988;30(3):153-158.
- Tosun G, Kose S, İşbilen Başok B, Altunyurt S. First-trimester placental function in levothyroxine-using pregnant women: a case-control study. Gynecol Endocrinol. 2020;36(3):233-237.
- Toloza FJK, Abedzadeh-Anaraki S, Maraka S. Subclinical hypothyroidism in pregnancy. Curr Opin Endocrinol Diabetes Obes. 2019;26(5):225-231.
- Maraka S, Ospina NM, O'Keeffe DT, et al. Subclinical hypothyroidism in pregnancy: a systematic review and meta-analysis. Thyroid. 2016;26(4):580-590.
- Kurek Eken M, Tüten A, Ozkaya E, et al. Evaluation of the maternal and fetal risk factors associated with neonatal care unit hospitalization time. J Matern Fetal Neonatal Med. 2016;29(21): 3553-3557.
- Tranquilli AL, Landi B, Giannubilo SR, Sibai BM. Preeclampsia: No longer solely a pregnancy disease. Pregnancy Hypertens. 2012;2(4):350-357.
- Stagnaro-Green A. Overt hyperthyroidism and hypothyroidism during pregnancy. Clin Obstet Gynecol. 2011;54(3):478-487.
- Wang YF, Yang HX. [Clinical analysis of hypothyroidism during pregnancy]. Zhonghua Fu Chan Ke Za Zhi. 2007;42(3):157-160.
- Li X, Zhang W, Lin J, et al. Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases. J Clin Hypertens (Greenwich). 2018;20(6):1049-1057.
- Zhang Y, Dai X, Yang S, et al. Maternal low thyroxin levels are associated with adverse pregnancy outcomes in a Chinese population. PLoS One. 2017;12(5):e0178100.
- Gietka-Czernel M, Glinicki P. Subclinical hypothyroidism in pregnancy: controversies on diagnosis and treatment. Pol Arch Intern Med. 2021;131(3):266-275.
- Busnelli A, Vannucchi G, Paffoni A, et al. Levothyroxine dose adjustment in hypothyroid women achieving pregnancy through IVF. Eur J Endocrinol. Oct 2015;173(4):417-424.
- Kashi Z, Bahar A, Akha O, Hassanzade S, Esmaeilisaraji L, Hamzehgardeshi Z. Levothyroxine dosage requirement during pregnancy in well-controlled hypothyroid women: a longitudinal study. Glob J Health Sci. 2015;8(4):227-233.
- Su X, Liu Y, Li G, et al. Associations of hypothyroxinemia with risk of preeclampsia–eclampsia and gestational hypertension. original research. Front Endocrinol. 2021;12
- Wang J, Gong XH, Peng T, Wu JN. Association of thyroid function during pregnancy with the risk of pre-eclampsia and gestational diabetes mellitus. Endocr Pract. 2021;27(8):819-825.
- Maraka S, Singh Ospina NM, O'Keeffe DT, et al. Effects of levothyroxine therapy on pregnancy outcomes in women with subclinical hypothyroidism. Thyroid. 2016;26(7):980-986.
- Jiao X-F, Zhang M, Chen J, et al. The impact of levothyroxine therapy on the pregnancy, neonatal and childhood outcomes of subclinical hypothyroidism during pregnancy: an updated systematic review, meta-analysis and trial sequential analysis. systematic review. Front Endocrinol. 2022;2022:13.
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Original Article |
| Authors | |
| Early Pub Date | September 26, 2023 |
| Publication Date | September 28, 2023 |
| Published in Issue | Year 2023 Volume: 6 Issue: 5 |
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