Abstract:Objective To investigate the association of maternal mild TSH elevation and subclinical hypothyroidism (SCH) in the first trimester with gestational diabetes mellitus (GDM) and the effect of levothyroxine treatment among Thyroid peroxidase antibody (TPOAb) negative pregnant women.Methods According to inclusion and exclusion criteria, a total of 15510 pregnant women were included in this birth cohort study, whose last menstrual period was between May 2016 and April 2019. Based on the upper limit of the TSH pregnancy-specific reference range (2.9mIU/L), pregnant women were divided into euthyroid (14787), untreated mild TSH elevation (n=255), treated mild TSH elevation (n=78), untreated SCH (n=111), and treated SCH (n=279) groups. Modified Poisson regression was applied to estimate the association of maternal mild TSH elevation and SCH with GDM as well as the effect of levothyroxine treatment.Results When euthyroid pregnancy women were used as the reference group, there was no association between untreated mild TSH elevation and GDM (P>0.05), while untreated SCH increased the risk of GDM (RR=1.39, 95% CI:1.12-1.73, P=0.003). When untreated pregnancy women were used as the reference group, there was no significant difference between untreated and treated mild TSH elevation group, while treated SCH group was associated with a decreased the risk of GDM (RR=0.54, 95% CI:0.39-0.76, P<0.001).Conclusion For TPOAb negative SCH pregnant women, an elevated level of TSH was associated with increased risk of GDM and LT4 treatment could decrease the risks.
苏涛, 徐金辉, 韩娜, 计岳龙, 周双, 包鹤龄, 刘峥, 罗树生, 王海俊. 促甲状腺激素轻度升高和亚临床甲状腺功能减退且TPOAb抗体阴性对妊娠期糖尿病的影响[J]. 中国生育健康杂志, 2022, 33(6): 507-512.
SU Tao, XU Jinhui, HAN Na, JI Yuelong, ZHOU Shuang, BAO Heling, LIU Zheng, LUO Shusheng, WANG Haijun. The association of maternal mild TSH elevation and subclinical hypothyroidism with gestational diabetes mellitus among TPOAb negative pregnant women. Chinese Journal of Reproductive Health, 2022, 33(6): 507-512.
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