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Live birth rate. Thirteen of the included articles analyzed the LBR as an outcome. Outcomes were pooled from the studies, and the results showed that the LBR was non-significantly lower in women with SCH (TSH cut-off value: 2.5 mIU/L) than in women with normal thyroid function (OR: 0.93; 95% CI (0.77, 1.12), P = 0.43).
This article clearly shows that TSH values vary significantly during the first trimester of pregnancy. Changes encompass two stable periods, the normal TSH one at the very beginning of pregnancy and the low TSH one at weeks 9 to 12. This is followed a partial return of TSH to the initial values.
11 Αυγ 2023 · Women with established hypothyroidism should have a TSH test as soon as pregnancy is confirmed. They also should immediately increase their levothyroxine dose, because thyroid hormone requirements increase during pregnancy. (See below for specific dosing recommendations.)
Overall then, TSH tends to be lower than usual with a transient rise in free T4 levels during the 1st trimester. TSH then normalises for the rest of pregnancy, and there is a modest fall in Free T4 in 2nd and 3rd trimester, but still within normal ranges; free T3 levels are similar.
It is important for pregnant women to have enough thyroid hormone during pregnancy for normal pregnancy and babies’ normal development. Severe hypothyroidism in pregnant women is known to cause problems in pregnancy such as premature delivery, miscarriages and poor growth in babies.
15 Φεβ 2014 · When preferred FT 4 assay techniques are unavailable, a serum TSH level is a more accurate assessment of maternal thyroid status, and measurements of total thyroxine and the FT 4 index can be used ...
Overt hypothyroidism should be treated in pregnancy. This includes women with a TSH above the reference range with a decreased T4, AND all women with a TSH >10 mIU/L, irrespective of the level of FT4. Consensus-based recommendation
