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KMID : 0338420180330030552
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The Korean Journal of Internal Medicine
2018 Volume.33 No. 3 p.552 ~ p.560
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Reference intervals of thyroid hormones during pregnancy in Korea, an iodine-replete area
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Kim Hye-Jeong
Cho Yoon-Young
Kim Sun-Wook
Kim Tae-Hyuk
Jang Hye-Won
Lee Soo-Youn
Choi Suk-Joo
Roh Cheong-Rae
Kim Jong-Hwa
Chung Jae-Hoon
Oh Soo-Young
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Abstract
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Background/Aims: Maternal thyroid dysfunction has been associated with adverse pregnancy outcomes. The purpose of our study was to establish trimester-specific reference intervals for thyroid hormones in pregnant women in Korea, where iodine intake is more than adequate and to examine pregnancy and perinatal outcomes in their offspring.
Methods: Among 459 healthy pregnant women who were screened, we enrolled 417 subjects who had negative results for thyroid autoantibodies. Serum thyroid stimulating hormone (TSH) and free thyroxine were measured using an immunoradiometric assay. Urine iodine concentration was measured using inductively coupled plasma-mass spectrometry in 275 women. Reference ranges of thyroid hormones were determined according to the guidelines of the National Academy of Clinical Biochemistry. Pregnancy and perinatal outcomes were compared according to maternal thyroid function.
Results: The reference ranges of serum TSH were 0.03 to 4.24 mIU/L in the first trimester, 0.13 to 4.84 mIU/L in the second trimester, and 0.30 to 5.57 mIU/L in the third trimester. Pregnancy and perinatal outcomes did not vary in mothers with subtle changes in thyroid function.
Conclusions: Trimester-specific thyroid hormone reference intervals in Korean pregnant women differ from those of other countries with different iodine nutrition status and ethnicity. The establishment of population-based, reliable trimester-specific reference intervals is critical for the interpretation of thyroid function in pregnant women to avoid unnecessary tests and treatments.
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KEYWORD
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Thyroid hormones, Reference intervals, Pregnancy, Iodine, Republic of Korea
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