ArticleEuropean thyroid journal2022
Pregnancy disrupts the accuracy of automated fT4 immunoassays.
Article in European thyroid journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- 2026 ETA guideline on interference in immunoassay measurements used in assessment of thyroid function.European thyroid journal · 2026Guideline
- Association between maternal thyroid function and adverse outcomes of pregnant women and offspring: evidence from an umbrella review.BMC pregnancy and childbirth · 2026Pooled it
- Pregnancy-specific Reference Intervals for TSH and FT4: Novel Insights From Preconception-gestation Longitudinal Data.The Journal of clinical endocrinology and metabolism · 2026Article
- Third-trimester estradiol is associated with isolated maternal hypothyroxinemia and attenuated TSH-FT4 coupling: evidence from rats and human astrocytes.Frontiers in endocrinology · 2026Article
- Lugol's Iodine as a Key Treatment in Transient Gestational Thyrotoxicosis: A Case Report.Case reports in endocrinology · 2026Article
- Investigating factors associated with thyroid hormone measurements during pregnancy.European thyroid journal · 2025Article
- Importance of iodide sufficiency and normal thyroid function in fertility and during gestation.Thyroid research · 2025Review
- Evaluation of the Current State of Thyroid Hormone Testing in Human Serum-Results of the Free Thyroxine and Thyrotropin Interlaboratory Comparison Study.Thyroid : official journal of the American Thyroid Association · 2025Article
- A case of unexpected thyroid storm in postpartum.The Journal of international medical research · 2025Article
- The impact of insulin resistance on thyroid function and the prevalence of thyroid follicular nodular disease in pregnant women.European thyroid journal · 2025Article
- EndoCompass Project: Endocrine Laboratory Medicine.Hormone research in paediatrics · 2025Review
- Analysis of free, unbound thyroid hormones by liquid chromatography-tandem mass spectrometry: A mini-review of the medical rationale and analytical methods.Analytical science advances · 2023Review
- Isolated Maternal Hypothyroxinemia: Adverse Maternofetal Outcomes but Uncertainty About Treatment Remains.Thyroid : official journal of the American Thyroid Association · 2023Article
- Hypothyroidism: The difficulty in attributing symptoms to their underlying cause.Frontiers in endocrinology · 2023Review
- Serum CD5L as potential biomarker of thyroid hormone status during pregnancy.BioFactors (Oxford, England)Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Thyroid hormone measurements are often performed in pregnant women, as hypo- and hyperthyroidism during pregnancy can severely affect the fetus. Serum free thyroxine (fT4) measurements are well known for their analytical challenges, due to low serum concentrations and the subtle equilibrium between free and bound T4 (to thyroid-binding globulin (TBG), transthyretin and albumin). Pregnant women have high TBG concentrations due to an increase in human chorionic gonadotropin (hCG) and estrogen and lower albumin concentrations which change the equilibrium and may affect the validity of fT4 measurements in their samples. As accurate serum fT4 measurements in pregnant women are important for the long-term health of the fetus, we aimed to evaluate the accuracy of several fT4 immunoassays in the serum of pregnant women. Methods: FT4 was measured in healthy controls and pregnant women using a candidate-reference method (LC-MS/MS) and five commercially available automated immunoassays (Alinity (Abbott), Atellica (Siemens), Cobas (Roche), Lumipulse (Fujirebio) and UniCel DXI (Beckman Coulter)). Method comparisons (Bland Altman plots and Passing and Bablok analyses) were performed. Results: Serum samples from both healthy controls (n = 30) and pregnant women (n = 30; mean gestational age, 24.8 weeks) were collected. The fT4 immunoassays deviated +7 to +29% more from the LC-MS/MS in serum samples of pregnant women than healthy controls (falsely high). Conclusions: Our results indicate that immunoassays overestimate fT4 in pregnant women, which might lead to an overestimation of thyroid status. Physicians and laboratory specialists should be aware of this phenomenon to avoid drawing false conclusions about thyroid function in pregnant women.
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