ArticleFrontiers in endocrinology2021
Early Levothyroxine Treatment for Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy: The St Carlos Gestational and Thyroid Protocol.
Article in Frontiers in endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Obstetric and offspring outcomes in isolated maternal hypothyroxinaemia: a systematic review and meta-analysis.Journal of endocrinological investigation · 2023Pooled it
- Development and validation of a prediction nomogram for adverse pregnancy outcomes among urban Chinese women with hypothyroxinemia during early pregnancy.BMC pregnancy and childbirth · 2025Article
- Key Messages of the Iodine Deficiency Working Group (AKJ): Maternal Hypothyroxinemia Due to Iodine Deficiency and Endocrine Disruptors as Risks for Child Neurocognitive Development.Geburtshilfe und Frauenheilkunde · 2025Article
- Article
- Effect of levothyroxine treatment on serum lipids and pregnancy outcomes in pregnant women with isolated hypothyroxinemia.Scientific reports · 2025Article
- Effect of different initiation timing of levothyroxine on pregnancy outcomes and development of offspring in women with gestational subclinical hypothyroidism.Pakistan journal of medical sciences · 2024Article
- Early treatment will prevent feto-maternal complications in thyroid disorders during pregnancy: A prospective study.Journal of family medicine and primary care · 2023Article
- Reducing the Rate of Premature Births through Early Diagnosis and Pregnancy-Adapted Treatment of Hypothyroidism.Geburtshilfe und Frauenheilkunde · 2023Article
- Iodine Deficiency, Maternal Hypothyroxinemia and Endocrine Disrupters Affecting Fetal Brain Development: A Scoping Review.Nutrients · 2023Article
- Preconception Counseling in Patients with Hypothyroidism and/or Thyroid Autoimmunity.Medicina (Kaunas, Lithuania) · 2022Review
- Urinary Phthalate Biomarkers during Pregnancy, and Maternal Endocrine Parameters in Association with Anthropometric Parameters of Newborns.Children (Basel, Switzerland) · 2022Article
- Effect of Levothyroxine Sodium Tablets on Pregnancy Outcome and Offspring Development Quotient of SCH during Pregnancy.Journal of healthcare engineering · 2022Article
- The Consumption of Food-Based Iodine in the Immediate Pre-Pregnancy Period in Madrid Is Insufficient. San Carlos and Pregnancy Cohort Study.Nutrients · 2021Article
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Authors and funding
26 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The optimal maternal levels of thyroid hormones (TH) during the first trimester of gestation have not been established, nor has the ideal moment to initiate levothyroxine treatment (LT) to improve the evolution of gestation and fetal development. Cut-off points for Thyroid-stimulating hormone (TSH) <2.5 µIU/mL and free thyroxine (FT4)>7.5 pg/mL have been recommended. There are no data on whether initiation of LT <9th Gestational Week (GW) can have a favourable impact. Objective: To define the TSH/FT4 percentiles corresponding with 2.5 µIU/mL and 7.5 pg/mL levels, respectively, at GW8 (Study 1), and evaluate the effects of protocol-based LT before GW9 on gestation evolution, in women with TSH ≥2.5 µIU/mL and/or FT4≤ 7.5 pg/mL (study 2). Subjects: 2768 consecutive pregnant women attending the first gestational visit from 2013-2014 and 3026 from 2015-2016 were eligible for Study I and 2 respectively. A final 2043 (study 1) and 2069 (study 2) women were assessed in these studies. Results: Study 1: The FT4 level of 7.5 pg/mL corresponds with the 17.9th percentile, a TSH level of 2.5 µIU/mL with the 75.8 Conclusions: Early LT in women with suboptimum levels of TSH/FT4 (≥2.5µIU/mL/≤7.5 pg/ml) at or before GW9 is safe and improves gestation progression. These data support the recommendation to adopt these cut-off points for LT initiation, which should be started as early as possible.
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