ArticleBMC pregnancy and childbirth2025
The association of early pregnancy, particularly persistent isolated maternal hypothyroxinemia, with adverse obstetric and perinatal outcomes.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Third-trimester estradiol is associated with isolated maternal hypothyroxinemia and attenuated TSH-FT4 coupling: evidence from rats and human astrocytes.Frontiers in endocrinology · 2026Article
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Abstract
objectiveWe aimed to assess the association of early pregnancy isolated maternal hypothyroxinemia (IMH), including persistent IMH, with adverse obstetric and perinatal outcomes.
methodsThis study was a large-scale retrospective cohort study based at a tertiary hospital in Shanghai, China between January 2013 and December 2016. Independent t-tests, chi-square tests, and stratified univariate and multivariate logistic regression analyses were performed to examine the associations between IMH and adverse pregnancy outcomes. Trend chi-square tests were used to evaluate the differences in the incidence of adverse pregnancy outcomes among the euthyroid, transient IMH, and persistent IMH groups.
resultsA total of 37,734 women with singleton pregnancies were classified into the euthyroid group (n = 35,733) and the IMH group (n = 2,001), based on thyroid function test results obtained during early pregnancy (gestational weeks 11-13). After adjusting for confounders, stratified analyses showed that IMH was associated with increased risks of gestational diabetes mellitus (GDM) primarily in women aged < 35 years and those with pre-pregnancy BMI < 24 kg/m². In women aged ≥ 35 years with a BMI ≥ 24 kg/m², IMH was associated with an elevated risk of preeclampsia. Additionally, in women aged ≥ 35 years, IMH was significantly linked to preterm birth and low birth weight (LBW). Fetal distress and macrosomia were consistently associated with IMH across all subgroups. No significant interaction effects were observed between maternal age or BMI and IMH on adverse outcomes. Trend chi-square tests indicated a linear increase in the incidence of preeclampsia, preterm birth, macrosomia, emergency cesarean section, and fetal distress across the euthyroid, transient IMH, and persistent IMH groups.
conclusionEarly pregnancy IMH is associated with increased risks of several adverse pregnancy outcomes, and stratified analyses suggest that these risks may vary by maternal age and pre-pregnancy BMI. Both transient and persistent IMH were associated with an increased risk of adverse pregnancy outcomes, with persistent IMH related to a broader spectrum of adverse events.
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