BES2003 Poster Presentations Thyroid (27 abstracts)
The controlled antenatal thyroid screening study (CATS) - first observations
JH Lazarus 1 , NJ Wald 2 , C Angele 1 , LM George 2 , PT Seed 2 , IL Taylor 1 & AB Parkes 1
1Department of Medicine, University of Wales College of Medicine, Cardiff, Wales, UK; 2Wolfson Institute of Preventative Medicine, St Barts and The Royal London Hospitals, London, UK.
Normal pregnancy is associated with significant but reversible changes in thyroid function. However, maternal thyroid dysfunction during early pregnancy has been associated with neuro-intellectual impairment of the child. The CATS study, a randomised controlled study, has been initiated in order to ascertain if screening for abnormalities in thyroid function in early pregnancy (8 - 16 weeks gestation), with thyroxine replacement in appropriate cases, would be effective in reducing neuro-intellectual impairment. The study has been running in South Wales for 6 months. Ethical approval for this study has been given by all the participating South Wales Trusts.
To date, 986 women have been enrolled into the study and randomised into a 'screen' group (494, mean gestational age 12.8 plus/minus 1.6 weeks) and 'control' group (492, mean gestational age 12.7 plus/minus 1.6 weeks). Thyroid function tests have been performed on the 'screen' group; TSH 1.28 milli-units per litre (range 0.02 - 9.98), free T4 13.7 picomoles per litre (range 9.4 - 20.9). Using previously defined 97.5th centile for TSH of 4.2 milli-units per litre and 2.5th centile for free T4 of 11.2 picomoles per litre, 21 women are receiving thyroxine replacement (0.15 milligrams per day) and have be doing so for a mean of 9.5 weeks (range 1 - 19 weeks). To date, none of these women have shown any adverse effects of the treatment.
Thyroid function tests on serum samples collected at recruitment from the women randomised to the 'control' group will be analysed at term. The children of women found to have impaired thyroid function, together with the children of the mothers in the thyroxine replacement group will be assessed by a psychologist at 2 years of age.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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