What is it about?
During pregnancy, the thyroid is stimulated by human chorionic gonadotropin (hCG). This leads to an increase in FT4 and a decrease in TSH. We previously found that high-normal FT4 concentrations are associated with a higher risk of pre-eclampsia. In this paper, we wanted to investigate if this risk differs according to the relative amount of hCG stimulation during the time of blood sampling. The reason for this question is that if the cause of a high-normal FT4 concentration is a high hCG concentration, this is most likely a normal physiological response - believed to not lead to adverse outcomes. However, if a women has a high-normal FT4 with a low hCG, another cause can be suspected - such causes are more likely to be pathological, and thus reflect actual underlying thyroid pathology.
Featured Image
Why is it important?
These finding allow us to identify which women with a high FT4 have a higher risk. Such sub-stratification is important to identify which women are at a higher risk for pre-eclampsia. In addition, it also allows us to say something about what causes of a high FT4 may lead to pre-eclampsia.
Perspectives
This is the first study that shows that hCG may be useful for interpreting thyroid function measurement during pregnancy in a more specific way. It fits with the general trend of more personalized medicine and incorporates the use of physiological knowledge. Eventually, this concept may allow us to define which women with the exact same thyroid profile may need further work-ups, thorough follow-up or eventreatment, and which do not. We are currently further studying this concept and hope that our results will be replicated and incorporated into clinical trials (see for example our recent paper in JCEM entitled: Thyroid autoimmunity impairs the thyroidal response to hCG: two population-based prospective cohort studies. https://www.ncbi.nlm.nih.gov/pubmed/27754809).
MD Tim IM Korevaar
Erasmus Universiteit Rotterdam
Read the Original
This page is a summary of: The Risk of Preeclampsia According to High Thyroid Function in Pregnancy Differs by hCG Concentration, The Journal of Clinical Endocrinology & Metabolism, December 2016, Endocrine Society,
DOI: 10.1210/jc.2016-2397.
You can read the full text:
Resources
Contributors
The following have contributed to this page
