Miscarriage Research Today is a free monthly online journal that collates and summarizes the latest research about Miscarriage, including details on signs, symptoms, recurrent, pregnancy.

Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death.

Benhadi N, Wiersinga WM, Reitsma JB, Vrijkotte TG, Bonsel GJ

Departments of Endocrinology and Metabolism Clinical Epidemiology, Biostatistics and Bioinformatics Social Science, Academic Medical Centre of the University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. n.benhadi@amc.uva.nl

BACKGROUND: To examine the relationship between maternal TSH and free thyroxine (FT(4)) concentrations in early pregnancy and the risk of miscarriage, fetal or neonatal death. METHOD: Cohort study of 2497 Dutch women. TSH, FT(4), and thyroid peroxidase antibodies concentrations were determined at first booking. Child loss was operationalized as miscarriage, fetal or neonatal death. Women with overt thyroid dysfunction were excluded. RESULTS: Twenty-seven cases of child loss were observed. The mean TSH and FT(4) level in the women with child loss was 1.48 mU/l and 9.82 pmol/l compared with 1.11 mU/l and 9.58 pmol/l in women without child loss. The incidence of child loss increased by 60% (OR=1.60 (95% confidence interval (CI): 1.04-2.47)) for every doubling in TSH concentration. This association remained after adjustment for smoking, age, parity, diabetes mellitus, hypertension, previous preterm deliveries, and previous preterm stillbirth/miscarriage (adjusted odds ratio=1.80 (95% CI: 1.07-3.03)). This was not true for FT(4) concentrations (OR=1.41 (95% CI: 0.21-9.40); P=0.724). CONCLUSION: In a cohort of pregnant women without overt thyroid dysfunction, the risk of child loss increased with higher levels of maternal TSH. Maternal FT(4) concentrations and child loss were not associated.

Published 12 May 2009 in Eur J Endocrinol, 160(6): 985-91.
Full-text of this article is available online (may require subscription).

© 2004-2010 Miscarriage Research Today. All Rights Reserved.