ECE2018 Oral Communications Benign thyroid diseases (5 abstracts)
Relationship between TSH values in the first trimester of pregnancy and obstetric and neonatal complications
Beatriz Torres Moreno 1 , Gabriela Castillo Carvajal 1 , Lucrecia Vegara Fernández 1 , Teresa López del Val 1 , Victoria Alcázar Lázaro 1 , Lina Benfail 2 , Covadonga Torres Carrera 2 , Concepción García Lacalle 3 , María Carmen Orizales Lago 4 & Leonardo Ramos Zuñiga 4
1Service of Endocrinology and Nutrition of the University Hospital Severo Ochoa, Leganés (Madrid), Spain; 2University Alfonso X El Sabio, Madrid, Spain; 3Clinical Analysis Service of the Severo Ochoa University Hospital, Leganés (Madrid), Spain; 4Service of Gynecology and Obstetrics of the University Hospital Severo Ochoa, Leganés (Madrid), Spain.
Introduction: In recent years, numerous studies on the relationship between the TSH of the first trimester of pregnancy and obstetric complications have been published, and in this context it has been recommended to treat with levothyroxine from certain values of TSH. The aim of this study was to determine the incidence of obstetric and neonatal complications in pregnancies with normal TSH (0.14 to 2.49 mcU/ml) as a basis for assessing complications in pregnancies with TSH between 2.5 and 4.9 mcU/ ml, both treated as not treated with levothyroxine.
Material and methods: Prospective and cohort study of 1184 pregnant women with TSH in between 0.14 and 4.9 mcU / ml in prenatal screening. Groups A were established: pregnancies with TSH 0.14–2.49 (903) and B: pregnancies with TSH 2.5–4.9 (281). Group B was divided by randomization into two subgroups: B1: no treatment with levothyroxine (146), and B2: treatment with levothyroxine (135). The variables spontaneous abortion, induced delivery, caesarean section, weight of the newborn and admission in neonates were collected and a descriptive and analytical analysis was performed with SPSS 19.0.
Results: There were no significant differences in the percentage of abortions between group A (2.7%), and groups B1 (4.8%), and B2 (4.4%). The percentage of deliveries induced in group A (12.7%) was significantly lower (P<0.001) than those of group B1 (39.0%), and group B2 (39.3%). The percentage of caesarean sections in group A (7.8%) were significantly lower (P<0.001) than those in group B1 (28.8%), and group B2 (23.0%). There were no significant differences in the weights of the newborns of group A (3186± 515 gr), B1 (3229±460 gr), and B2 (3187±449 gr) or in gestational age being in the group A of 38.7 weeks ±2.7; B1 38.5±5.28 and B2 38.42±5. The mean age of pregnant women in group A was 33 years± 5.04, B1 31.95± 5.22 and B2 31.95± 5.58. There was no significant difference in neonatal admissions between group A (8.9%) and B1 (11.0%). The percentage of admissions in neonates in group B2 (20.0%) was significantly higher (P<0.05) than in B1.
Conclusion: In pregnant women with TSH <2.5 mcU / ml in the first trimester there are fewer induced births and caesarean sections than in women with TSH between 2.5 and 4.9 mcU/ml. The treatment with levothyroxine from week twelve does not modify this difference.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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