Evidence map›Paper›PMID 35361138›Full record

ArticleBMC pregnancy and childbirth2022

Accurate interpretation of thyroid dysfunction during pregnancy: should we continue to use published guidelines instead of population-based gestation-specific reference intervals for the thyroid-stimulating hormone (TSH)?

Rana Turkal, Cem Armağan Turan, Onur Elbasan, Serenay Aytan, Burcu Çakmak, Büşra Gözaydınoğlu, Duygu Ceyda Takır, Ozan Ünlü, Günel Bahramzada, Ahmet Faruk Tekin and 5 more

Open access · goldAbstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.2field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 18 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Rana TurkalBiochemistry Laboratory, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey. ranaturkal@yahoo.com.
Cem Armağan TuranDepartment of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey.
Onur ElbasanSubdepartment of Endocrinology, Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey.
Serenay Aytan *Medical Student, School of Medicine, Marmara University, Istanbul, Turkey.
Burcu Çakmak *Medical Student, School of Medicine, Marmara University, Istanbul, Turkey.
Büşra Gözaydınoğlu *Medical Student, School of Medicine, Marmara University, Istanbul, Turkey.
Duygu Ceyda Takır *Medical Student, School of Medicine, Marmara University, Istanbul, Turkey.
Ozan ÜnlüDepartment of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey.
Günel BahramzadaDepartment of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey.
Ahmet Faruk TekinDepartment of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey.
Tülay ÇevlikBiochemistry Laboratory, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey.
Esra Esim BüyükbayrakDepartment of Gynecology and Obstetrics, School of Medicine, Marmara University, Istanbul, Turkey.
Önder ŞirikçiDepartment of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey.
Hülya GözüSubdepartment of Endocrinology, Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey.
Goncagül HaklarDepartment of Biochemistry, School of Medicine, Marmara University, Istanbul, Turkey.
Marmara University · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConsidering the changes in thyroid physiology associated with pregnancy and poor outcomes related to abnormal maternal thyroid function, international guidelines recommend using population-based trimester-specific reference intervals (RIs) for thyroid testing. If these RIs are not available in the laboratory, implementing recommended fixed cut-off values globally is still controversial. To address this issue, we aimed to establish appropriate RI of thyroid-stimulating hormone (TSH) in pregnant Turkish women for our laboratory and compare the prevalence of thyroid dysfunction based on the established and recommended criteria.

methodsOf 2638 pregnant women, 1777 women followed in the obstetric outpatient were enrolled in the reference interval study after applying exclusion criteria related to medical and prenatal history. A retrospective study was conducted by collecting data from July 2016 to March 2019. Serum TSH was measured by UniCel DxI 800 Immunoassay System (Beckman Coulter Inc., Brea, CA, USA). The study design relied on two approaches in order to classify pregnant women: trimester-specific and subgroup-specific; the latter involved dividing each trimester into two subgroups: T1

resultsThe lowest TSH value was detected at 8-12 weeks in early pregnancy, and the median value of TSH in the T1

conclusionsWe conclude that establishing gestation- and laboratory-specific RIs, especially for TSH, is essential for diagnosing thyroid disorders in pregnancy, and the recommended universal cut-off values, which may contribute to the risk of a misdiagnosis or a missed diagnosis, should be taken with caution in the clinical setting. However, regarding the fluctuation of thyroid function tests throughout pregnancy, trimester-specific RIs are insufficient, and implementing split phases is required.

Indexed as

Thyroid DiseasesThyrotropinFemaleHumansPregnancyRetrospective StudiesThyroxineThyrotropinThyroxineATAGestation-specificPregnancyReference intervalThyroid dysfunction

Identifiers

PMID35361138
PMCPMC8973886
OpenAlexW4221039768

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.