TY - JOUR

T1 - Association of Gestational Free and Total Triiodothyronine With Gestational Hypertension, Preeclampsia, Preterm Birth, and Birth Weight

T2 - An Individual Participant Data Meta-analysis

AU - Derakhshan, Arash

AU - Männistö, Tuija

AU - Chen, Liangmiao

AU - Osinga, Joris A. J.

AU - Ashoor, Ghalia

AU - Lu, Xuemian

AU - Bliddal, Sofie

AU - Tao, Fang-Biao

AU - Brown, Suzanne J.

AU - Vaidya, Bijay

AU - Hattersley, Andrew T.

AU - Itoh, Sachiko

AU - Popova, Polina V.

AU - Aminorroaya, Ashraf

AU - Kishi, Reiko

AU - Kianpour, Maryam

AU - Vasukova, Elena A.

AU - López-Bermejo, Abel

AU - Oken, Emily

AU - Chatzi, Leda

AU - Vafeiadi, Marina

AU - Bramer, Wichor M.

AU - Bassols, Judit

AU - Lertxundi, Aitana

AU - Fernández-Somoano, Ana

AU - Carrasco, Paula

AU - Auvinen, Juha

AU - Huang, Kun

AU - Feldt-Rasmussen, Ulla

AU - Grineva, Elena N.

AU - Alexander, Erik K.

AU - Pearce, Elizabeth N.

AU - Chaker, Layal

AU - Walsh, John P.

AU - Peeters, Robin P.

AU - Guxens, Mònica

AU - Suvanto, Eila

AU - Nicolaides, Kypros H.

AU - Korevaar, Tim I. M.

N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.

PY - 2024

Y1 - 2024

N2 - CONTEXT: Triiodothyronine (T3) is the bioactive form of thyroid hormone. In contrast to thyroid-stimulating hormone and free thyroxine, we lack knowledge on the association of gestational T3 with adverse obstetric outcomes.OBJECTIVE: To investigate the associaiton of gestational free or total T3 (FT3 or TT3) with adverse obstetric outcomes.METHODS: We collected individual participant data from prospective cohort studies on gestational FT3 or TT3, adverse obstetric outcomes (preeclampsia, gestational hypertension, preterm birth and very preterm birth, small for gestational age [SGA], and large for gestational age [LGA]), and potential confounders. We used mixed-effects regression models adjusting for potential confounders.RESULTS: The final study population comprised 33 118 mother-child pairs of which 27 331 had data on FT3 and 16 164 on TT3. There was a U-shaped association of FT3 with preeclampsia (P = .0069) and a J-shaped association with the risk of gestational hypertension (P = .029). Higher TT3 was associated with a higher risk of gestational hypertension (OR per SD of TT3 1.20, 95% CI 1.08 to 1.33; P = .0007). A lower TT3 but not FT3 was associated with a higher risk of very preterm birth (OR 0.72, 95% CI 0.55 to 0.94; P = .018). TT3 but not FT3 was positively associated with birth weight (mean difference per 1 SD increase in TT3 12.8, 95% CI 6.5 to 19.1 g, P < .0001) but there was no association with SGA or LGA.CONCLUSION: This study provides new insights on the association of gestational FT3 and TT3 with major adverse pregnancy outcomes that form the basis for future studies required to elucidate the effects of thyroid function on pregnancy outcomes. Based on the current study, routine FT3 or TT3 measurements for the assessment of thyroid function during pregnancy do not seem to be of added value in the risk assessment for adverse outcomes.

AB - CONTEXT: Triiodothyronine (T3) is the bioactive form of thyroid hormone. In contrast to thyroid-stimulating hormone and free thyroxine, we lack knowledge on the association of gestational T3 with adverse obstetric outcomes.OBJECTIVE: To investigate the associaiton of gestational free or total T3 (FT3 or TT3) with adverse obstetric outcomes.METHODS: We collected individual participant data from prospective cohort studies on gestational FT3 or TT3, adverse obstetric outcomes (preeclampsia, gestational hypertension, preterm birth and very preterm birth, small for gestational age [SGA], and large for gestational age [LGA]), and potential confounders. We used mixed-effects regression models adjusting for potential confounders.RESULTS: The final study population comprised 33 118 mother-child pairs of which 27 331 had data on FT3 and 16 164 on TT3. There was a U-shaped association of FT3 with preeclampsia (P = .0069) and a J-shaped association with the risk of gestational hypertension (P = .029). Higher TT3 was associated with a higher risk of gestational hypertension (OR per SD of TT3 1.20, 95% CI 1.08 to 1.33; P = .0007). A lower TT3 but not FT3 was associated with a higher risk of very preterm birth (OR 0.72, 95% CI 0.55 to 0.94; P = .018). TT3 but not FT3 was positively associated with birth weight (mean difference per 1 SD increase in TT3 12.8, 95% CI 6.5 to 19.1 g, P < .0001) but there was no association with SGA or LGA.CONCLUSION: This study provides new insights on the association of gestational FT3 and TT3 with major adverse pregnancy outcomes that form the basis for future studies required to elucidate the effects of thyroid function on pregnancy outcomes. Based on the current study, routine FT3 or TT3 measurements for the assessment of thyroid function during pregnancy do not seem to be of added value in the risk assessment for adverse outcomes.

KW - Pregnancy

KW - Female

KW - Humans

KW - Infant, Newborn

KW - Triiodothyronine

KW - Birth Weight

KW - Hypertension, Pregnancy-Induced/epidemiology

KW - Pre-Eclampsia/epidemiology

KW - Premature Birth/epidemiology

KW - Prospective Studies

KW - Thyroid Hormones

KW - Thyrotropin

KW - Thyroxine

U2 - 10.1210/clinem/dgad631

DO - 10.1210/clinem/dgad631

M3 - Journal article

C2 - 37878891

VL - 109

SP - e1290-e1298

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 3

ER -