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Subclinical hypothyroidism increased the risk of placental abruption and poor neonatal outcomes

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 Q Is subclinical hypothyroidism (SH) a risk factor for poor pregnancy and neonatal outcomes?

Clinical impact ratings Obstetrics ★★★★★★★


Embedded ImageDesign:

cohort study with follow up at birth.

Embedded ImageSetting:

a county hospital in Dallas, Texas, USA.

Embedded ImagePatients:

16 093 pregnant women (mean age 25.5 y) enrolled for prenatal care at ⩽20 weeks of gestation who had thyroid screening.

Embedded ImageRisk factors:

SH (elevated serum thyroid stimulating hormone [TSH] concentration ⩾97.5th percentile corrected for gestational age: range 2.74-5.09 mU/l and a normal serum free thyroxine concentration >0.680 ng/dl). Thyroid function tests were done using chemiluminescent assays for TSH and free thyroxine (Immulite 2000 Analyzer [Diagnostic Products Corporation, Los Angeles, CA]). Women were retrospectively identified as having SH.

Embedded ImageOutcomes:

pregnancy outcomes: gestational hypertension (intrapartum systolic blood pressure [BP] ⩾140 mm Hg or diastolic BP ⩾90 mm Hg), and severe preeclampsia (⩾1 of BP >160/110 mm Hg, serum creatinine >1.0 mg%, platelet …

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  • For correspondence: Dr B M Casey, University of Texas Southwestern Medical Center, Dallas, TX, USA.

  • Source of funding: no external funding.