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초록
Background and Objectives
Thyroid dysfunction during pregnancy can result in many complications for both mother and infant. Due to the physiologic changes in thyroid stimulating hormone (TSH) level during early pregnancy, it is recommend to use trimester-specific reference ranges for every population. We obtained the reference range of TSH during the first trimester in Korean women according to gestational week.
Materials and Methods
The study population consisted of pregnant women who had undergone a TSH screening during the first trimester of pregnancy (n=8365) and nonpregnant women (n=1835).
Results
Median concentration of serum TSH decreased significantly from the 5th to 8th week of gestation (median TSH concentration: 2.00 mIU/L for 5 weeks; 1.70 mIU/L for 6 weeks; 1.40 mIU/L for 7 weeks; 1.05 mIU/L for 8 weeks). However, there was no significant difference in median concentration of serum TSH from the 8th to 12th weeks of gestation. Using the fixed cutoff value of TSH ＞3.66 mIU/L, the diagnosis rate of subclinical hypothyroidism was 15.0% for 5 weeks, 10.0% for 6 weeks, 5.9% for 7 weeks, and 3.6% for 8-12 weeks.
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Fig. 1.
Serum thyroid stimulating hormone variation according to gestational week in 8365 Korean pregnant women.
Table 1.
Percentile values of TSH of non-pregnant and each gestational age pregnant women
| Gestational weeks | Number | TSH (mIU/L) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 2.5th | 5th | 25th | Median | 75th | 95th | 97.5th | p value∗ | p value† | ||
| Non-pregnant Pregnant (week) | 1835 | 0.31 | 0.59 | 1.26 | 1.87 | 2.73 | 4.73 | 5.70 | ||
| 5 | 247 | 0.52 | 0.69 | 1.33 | 2.00 | 3.00 | 5.50 | 6.05 | 0.061 | |
| 6 | 793 | 0.34 | 0.48 | 1.11 | 1.70 | 2.59 | 4.50 | 5.58 | ＜0.001 | ＜0.001 |
| 7 | 1384 | 0.08 | 0.20 | 0.77 | 1.40 | 2.17 | 3.91 | 4.73 | ＜0.001 | ＜0.001 |
| 8 | 1762 | 0.03 | 0.06 | 0.49 | 1.05 | 1.81 | 3.50 | 4.50 | ＜0.001 | ＜0.001 |
| 9 | 1156 | 0.02 | 0.03 | 0.44 | 0.99 | 1.72 | 3.68 | 4.38 | 0.058 | ＜0.001 |
| 10 | 374 | 0.01 | 0.02 | 0.35 | 0.87 | 1.61 | 3.36 | 3.90 | 0.083 | ＜0.001 |
| 11 | 563 | 0.00 | 0.02 | 0.43 | 1.07 | 1.73 | 3.13 | 3.52 | 0.139 | ＜0.001 |
| 12 | 1841 | 0.02 | 0.04 | 0.49 | 1.03 | 1.69 | 3.06 | 3.57 | 0.731 | ＜0.001 |
| 13 | 245 | 0.00 | 0.02 | 0.59 | 1.08 | 1.80 | 2.84 | 3.24 | 0.303 | ＜0.001 |
Table 2.
Prevalence of hypothyroidism with different diagnostic criteria
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