Horm Metab Res 2019; 51(03): 165-171
DOI: 10.1055/a-0855-7128
Endocrine Care

Reference Intervals for Thyroid Hormones During the First Trimester of Gestation: A Report from an Area with a Sufficient Iodine Level

Maryam Kianpour
1   Isfahan Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
,
Ashraf Aminorroaya
1   Isfahan Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
,
Massoud Amini
1   Isfahan Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
,
Awat Feizi
1   Isfahan Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2   Department of Biostatistics & Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
,
Mohsen Janghorbani
1   Isfahan Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2   Department of Biostatistics & Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
,
Saeideh Shokri
3   Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
,
Sima Aminorroaya Yamini
4   Department of Engineering and Mathematics, Sheffield Hallam University, Sheffield, UK
,
Maryam Farghadani
3   Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
,
Ali Hekmatnia
3   Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
,
Hossien Gharib
5   Mayo Clinic College of Medicine, Rochester, Minnesota, USA
› Author Affiliations
Funding The study was funded by the Endocrinology and Metabolism Research Center of Isfahan University of Medical Sciences in Isfahan, Iran; under the grant No. 394616. The authors declare that they have no competing financial interests.

Abstract

The physiological changes during pregnancy modulate the endocrine system. Therefore, both the American and the European thyroid associations recommend the use of local trimester-specific reference intervals. The purpose of this study was to establish the first trimester reference intervals for thyroid function tests in the central area of Iran. We examined 436 pregnant women in their first trimester of pregnancy, and 444 non-pregnant women in a cross sectional study. Serum levels of thyroid stimulating hormone (TSH), free thyroxin (FT4), free triiodothyronine (FT3), thyroid peroxidase antibody, urinary iodine concentration (UIC), and thyroid volume were measured for all subjects. The first trimester-specific reference intervals (2.5th–97.5th percentile) were determined for 185 pregnant women and 256 non-pregnant women with negative TPOAb, adequate iodine level (UIC≥150 μg/l in pregnant and UIC≥100 μg/l in non-pregnant women), and normal thyroid examination. We calculated multiples of the median (MoM) for TFTs to normalize the obtained data. The first trimester-specific reference intervals of serum TSH, FT4, and FT3 for pregnant women were 0.20–4.60 mIU/l, 9.0–18.02 pmol/l, and 3.40–5.64 pmol/l, respectively, while the corresponding figures for non-pregnant women were 0.59–5.60 mIU/l, 9.52–19.30 pmol/l, and 3.70–5.55 pmol/l, respectively. The first and 99th percentile MoM of TSH in pregnant women in their first-trimester was 0.026–4.61. The local normal reference ranges for the first trimester of pregnancy in central region of Iran were different from the ranges suggested by the ATA.



Publication History

Received: 09 October 2018

Accepted: 05 February 2019

Article published online:
12 March 2019

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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