ArticleJAMA network open2022
Association of Preconception Thyrotropin Levels With Fecundability and Risk of Spontaneous Abortion in China.
Article in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 37 citations in OpenAlex.
- Ambient Air Pollution, Preconceptional Thyrotropin Abnormalities, and the Risk of Preterm Birth: A Nationwide Chinese Cohort Study.Environment & health (Washington, D.C.) · 2026Article
- Association of cesarean delivery with time to pregnancy and risk of subsequent spontaneous abortion: A retrospective cohort study in China.Chinese medical journal · 2026Article
- Ambient biothermal stress, preconceptional thyrotropin abnormalities, and the risk of preterm birth: a nationwide Chinese cohort study.Nature communications · 2025Article
- Chromosomal miscarriage and pregnancy outcomes in recurrent pregnancy loss.Reproduction & fertility · 2025Article
- Iodine status of pregnant women in the Chinese plateau area - effects on thyroid function as well as adverse pregnancy and fetal outcomes.Asia Pacific journal of clinical nutrition · 2025Article
- Risk prediction for recurrent pregnancy loss based on routine inspections in the first trimester of pregnancy, a retrospective study in China.Frontiers in medicine · 2025Article
- Association between BMI and increased time-to-pregnancy in planned pregnancy couples: a cohort study in Guangzhou, China.BMC public health · 2024Article
- Evaluating the progression to abnormal thyrotropin in euthyroid preconception women: a population-based study.Thyroid research · 2024Article
- Update on therapeutic use of levothyroxine for the management of hypothyroidism during pregnancy.Endocrine connections · 2024Review
- Associations of gestational thyrotropin levels with disease progression among pregnant women with differentiated thyroid cancer: a retrospective cohort study.Frontiers in endocrinology · 2024Article
- Impact of thyroid-stimulating hormone levels after controlled ovarian hyperstimulation onFrontiers in endocrinology · 2023Article
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16 authors at 5 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Importance: Abundant evidence suggests thyroid dysfunction is associated with adverse pregnancy outcomes. However, associations of preconception thyrotropin levels outside of reference range with reproductive health outcomes are not well characterized. Objective: To evaluate the associations of preconception thyrotropin levels with time to pregnancy (TTP) and risk of spontaneous abortion (SA). Design, Setting, and Participants: This population-based cohort study used data from the Chinese National Free Prepregnancy Checkups Project. Female participants aged 20 to 49 years who were trying to conceive were enrolled between January 1, 2013, and December 31, 2016, for the analysis of TTP or SA. Data were analyzed between August 1, 2020, and July 5, 2021. Exposures: Levels of thyrotropin within 1 year prior to pregnancy. Main Outcomes and Measures: The main outcomes were TTP, assessed using hazard ratios (HRs), and SA, assessed using odds ratios (ORs), according to preconception thyrotropin levels. Thyrotropin dose-response associations were assessed using restricted cubic spline regression. Results: Among 11 194 002 female participants (mean [SD] age, 27.56 [5.10] years) in the TTP cohort, 4 739 421 (42.34%) participants became pregnant within 1 year. Both low and high preconception thyrotropin levels were associated with delayed TTP compared with thyrotropin levels of 0.37 to 2.49 mIU/L (thyrotropin <0.10 mIU/L: HR, 0.90; 95% CI, 0.89-0.92; thyrotropin 4.88-9.99 mIU/L: HR, 0.86; 95% CI, 0.86-0.87; thyrotropin ≥10.00 mIU/L: HR, 0.78; 95% CI, 0.77-0.79). In the SA analysis cohort including 4 678 679 pregnancies, 108 064 SA events (2.31%) were documented. High thyrotropin groups showed an increased risk of SA compared with the group with thyrotropin levels of 0.37 to 2.49 mIU/L (thyrotropin 4.88-9.99 mIU/L: OR, 1.33; 95% CI, 1.28-1.38; thyrotropin ≥10.00 mIU/L: OR, 1.25; 95% CI, 1.14-1.36). Preconception thyrotropin levels showed an inverted J-shaped dose-response association with TTP (χ2 = 311.29; nonlinear P < .001) and a J-shaped dose-response association with SA (χ2 = 58.29; nonlinear P < .001). Conclusions and Relevance: In this cohort study, preconception thyrotropin levels outside of reference range were associated with increased risk of reduced fecundity and SA. These findings may provide insights for the implementation of preconception thyroid function screening and the design of future levothyroxine supplementation trials.
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