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Endocrine Abstracts (2024) 101 OP08-05 | DOI: 10.1530/endoabs.101.OP-08-05

ETA2024 Oral Presentations Oral Session 8: Pregnancy (5 abstracts)

Maternal thyroid function and biochemical markers of placental function in early pregnancy

Maja Lundgaard 1 , Marianne Sinding 2 , Anne Sørensen 2 , Aase Handberg 1 , Stig Andersen 3 , Nanna Torp 1 & Stine Andersen 1


1Aalborg University Hospital, Department of Clinical Biochemistry, Denmark; 2Aalborg University Hospital, Department of Obstetrics, Denmark; 3Aalborg University Hospital, Department of Geriatrics, Denmark


Objective: A link between levels of maternal thyroid hormones in pregnancy and the biochemical markers of placental dysfunction, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF), has been brought forward. Sparse evidence is available on the dynamics of sFlt-1 and PlGF in early pregnancy and the association with maternal thyroid function in early pregnant women specifically.

Methods: A retrospective cohort study within the North Denmark Region Pregnancy Cohort, 2011-2015, that contained maternal blood samples (n = 17,647) drawn in early pregnancy as part of prenatal screening for chromosomal anomalies. The samples were later used for assessment of thyroid-stimulating hormone (TSH) (ADVIA Centaur XPT, Siemens Healthineers). For the present study, a random sub-group of pregnant women (n = 858) were selected for measurement of sFlt-1 and PlGF as well as β-human chorionic gonadotropin (β-hCG) (Kryptor Compact, ThermoFisher Scientific). Regression analysis was used to evaluate the association between maternal TSH and β-hCG and pregnancy week-specific percentile levels of sFlt-1 and PlGF. Results were reported as geometric mean and adjusted beta coefficient (aβ) including potential confounders.

Results: Blood samples were drawn in median pregnancy week 10 (range 4-16). When evaluating the association between maternal TSH and categories of the placental biomarkers, higher percentile levels of sFlt-1 and PlGF associated with lower TSH in crude and adjusted analyses (Table). An opposite association between the placental biomarkers and β-hCG was found, with higher levels of β-hCG for increasing levels of sFlt-1 and PlGF (Table). Finally, high levels of β-hCG (> 75 percentile) associated with lower TSH (aβ 0.60 (95% CI: 0.48-0.75)).

Table 1
nMean TSH (mIU/l)95% CIMean β-hCG (IU/l)95% CI
sFlt-1
< 25 percentile2351.18Ref.35.8Ref.
25-75 percentile4150.860.760.65-0.8855.11.561.38-1.76
> 75 percentile2080.750.660.55-0.8182.62.342.05-2.67
PlGF
< 25 percentile2101.03Ref.46.4Ref.
25-75 percentile4070.950.970.83-1.1254.91.191.05-1.35
> 75 percentile2410.750.780.64-0.9659.91.271.10-1.47

Conclusions: In a large cohort of Danish pregnant women, higher levels of sFlt-1 and PlGF associated with lower levels of TSH. In contrast, higher levels of the placental biomarkers associated with higher levels of β-hCG. Considering the physiological link between TSH and β-hCG in early pregnancy, an intermediate role of β-hCG in the association between maternal thyroid function and biochemical markers of placental function may be proposed in this early window of pregnancy.

Volume 101

46th Annual Meeting of the European Thyroid Association (ETA) 2024

European Thyroid Association 

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