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  • Author: Johannes G Krabbe x
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Victor J. M. Pop V Pop, Medical and Clinical Pyschology, Tilburg University Tilburg School of Social and Behavioral Sciences, Tilburg, Netherlands

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Johannes G Krabbe J Krabbe, Clinical Chemistry Lab, Medisch Spectrum Twente, Enschede, Netherlands

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Maarten Broeren M Broeren, Clinical Chemistry Lab, Maxima Medical Centre, Veldhoven, Netherlands

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Wilmar Wiersinga W Wiersinga, endocrinology, Academic Medical Centre, Amsterdam, Netherlands

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Margaret P. Rayman M Rayman, Department of Nutritional Sciences, , University of Surrey, Guildford, United Kingdom of Great Britain and Northern Ireland

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Objective

Pregnancy is a state of inflammation facilitating implantation. Early isolated hypothyroxinaemia (IH) and increased inflammation (including obesity) have been associated with obstetric complications. The current study evaluated the association between IH, low ferritin and inflammation parameters (interleukin-6 (IL-6), C-reactive protein (CRP), human chorionic gonadotrophin (hCG) and obesity. Moreover, the course of these parameters throughout pregnancy was evaluated in relation to IH.

Methods

In the cross-sectional study (A) at 12 weeks, 2759 women participated and 2433 participated in the longitudinal study (B) with assessments at 12, 20 and 28 weeks gestation. At first trimester, 122 (4.4%) IH women (FT4 < 5th percentile, normal TSH levels) were compared with 2114 (76.6%) reference women (FT4 between 10 - 90th percentiles, normal TSH levels), in study B these figures were 99 (4.1%) and 1847 (75.9%), respectively.

Results

Cross-sectionally, compared to reference women, IH was independently associated with low ferritin (< 5th percentile, OR: 2.6, 95%CI: 1.4-4.9), high CRP (> 95th percentile: OR: 1.9, 95%CI: 1.04-3.7), low hCG (< median, OR: 2.1, 95%CI: 1.40-3.16), obesity (BMI>30, OR: 1.7, 95% CI: 1.1-2.9) and higher age (OR: 1.1, 95%CI: 1.04-1.15). Longitudinally, compared to reference women, women with first trimester IH, showed persistently and significantly lower ferritin and hCG levels, and persistently higher CRP and IL-6 levels throughout gestation.

Conclusions

Gestational IH could be viewed as a condition of increased inflammation, as reported in non-thyroidal illness syndrome. Less favorable inflammation parameters and low iron status during early gestation in IH women seem to persist throughout gestation.

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