Department of Endocrinology, Specialized Hospital for Active Treatment of Obstetrics and Gynecology "Dr Shterev", 1330 Sofia, Bulgaria.
Department of Organisation and Economics of Pharmacy, Faculty of Pharmacy, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.
Medicina (Kaunas). 2024 May 13;60(5):801. doi: 10.3390/medicina60050801.
: Pregnancy introduces various interfering factors that, alongside individual variations, impact the assessment of thyroid function tests. This underscores the necessity of defining trimester-specific reference intervals for thyroid-stimulating hormone (TSH) levels. Differences in population characteristics, including ethnicity, socio-economic factors, iodine prophylaxis, and obesity, emphasize the need to establish trimester-specific TSH ranges for women of reproductive age in the respective region or center. The aim of the present study was to establish first- and second-trimester-specific reference intervals for TSH and free thyroxine (FT4) in a relevant pregnant population. : A retrospective monocenter analysis utilized the electronic database of Ob/Gyn Hospital "Dr. Shterev", Sofia, Bulgaria. The analysis involved data from 497 pregnant and 250 non-pregnant women, all without evidence of thyroid dysfunction or a family history thereof, no indication of taking medication interfering with thyroid function, no evidence of levothyroxine treatment, and no history of sterility treatment. To establish the limits of the TSH reference range, the percentile method was applied using a bootstrapping procedure following the recommendations of the International Federation of Clinical Chemistry (IFCC). : Trimester-specific reference intervals for TSH and FT4 in our center were established as follows: first trimester-0.38-2.91 mU/L, FT4-12.18-19.48 pmol/L; second trimester-0.72-4.22 mIU/L and 9.64-17.39 pmol/L, respectively. We also established the normal reference range for the non-pregnant control group, which is similar to that applicable in our laboratory. : Our results differ from the fixed limits recommended by the American Thyroid Association, European Thyroid Association, and Endocrine Society Guidelines. Following the relevant established intervals would significantly impact timely diagnosis and therapy requirements for a substantial proportion of pregnant women.
: 妊娠会引入各种干扰因素，加上个体差异，影响甲状腺功能测试的评估。这凸显了为促甲状腺激素（TSH）水平定义特定孕期的参考区间的必要性。人口特征的差异，包括种族、社会经济因素、碘预防和肥胖，强调了在特定地区或中心为育龄妇女建立特定孕期 TSH 范围的必要性。本研究的目的是为相关孕妇群体建立 TSH 和游离甲状腺素（FT4）的第一和第二孕期特异性参考区间。: 采用保加利亚索非亚的 Ob/Gyn 医院“Shterev 博士”的电子数据库进行回顾性单中心分析。该分析涉及 497 名孕妇和 250 名非孕妇的数据，所有这些人都没有甲状腺功能障碍或家族病史、没有服用干扰甲状腺功能的药物、没有接受左甲状腺素治疗的证据，也没有不孕治疗的病史。为了确定 TSH 参考范围的界限，我们采用了国际临床化学联合会（IFCC）推荐的基于 bootstrap 的百分位法。: 我们中心建立的 TSH 和 FT4 的特定孕期参考区间如下：第一孕期 0.38-2.91 mU/L，FT4 12.18-19.48 pmol/L；第二孕期 0.72-4.22 mIU/L 和 9.64-17.39 pmol/L。我们还为非孕妇对照组建立了正常的参考范围，这与我们实验室适用的范围相似。: 我们的结果与美国甲状腺协会、欧洲甲状腺协会和内分泌学会指南推荐的固定范围不同。遵循相关的既定区间将显著影响相当一部分孕妇的及时诊断和治疗需求。
