Background
Materials and methods
Study design and participants, ethical considerations
Study outcomes
Statistical analysis
Results
Case summaries
Case | Basal state | Endocrinological basal value | TUS | pituitary gland MRI | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pregnacy (weeks) | Age (yr) | Symptoms | LT4 (µg/Day) | TSH (µIU/mL) | FT4 (ng/dL) | TgAb (U/mL) | TPOAb (U/mL) | BC (µg/dL) | ACTH (µg/dL) | Internal properties | Estimated weight (g) | ||
Group 1; AI group (n = 4) | |||||||||||||
1 | 11 | 34 | none | 25 | 2.6 | 0.9 | 45.6 | 14.7 | 6 | 28.9 | DP | 33.6 | NA |
2 | 14 | 42 | nausea | none | 4.88 | 0.96 | ≦ 10 | 5 | 10.5 | 5.7 | NP | 6.6 | NA |
3 | 15 | 33 | none | 25 | 1.46 | 1.44 | 1.24 | 1.28 | 10.7 | 22.5 | NP | none | Ratke cyst |
4 | 17 | 31 | nausea | 37.5 | 0.81 | 1.04 | 5.1 | <0.50 | 15.3 | 14.8 | DP | 13.1 | none |
Group 2; hypothyroid group with low basal serum cortisol but pass stimulation test (n = 3) | |||||||||||||
5 | 7 | 22 | fatigue | none | 10.8 | 0.96 | 183 | 1450 | 8 | 10.4 | DP | 20.3 | NA |
6 | 12 | 31 | nausea | none | 5.73 | 1.09 | 2.93 | <0.50 | 12 | 18.9 | NP | 8.1 | pituitary cyst |
7 | 15 | 37 | none | 75 | 1.17 | 1.21 | ≦ 10 | 12.43 | 10.4 | 10.8 | NP | 5.5 | NA |
Group 3; Hypothyroid group with adequate basal serum cortisol (n = 6) | |||||||||||||
8 | 14 | 41 | nausea | 50 | 1.2 | 0.99 | 0.78 | <0.50 | 11.1 | 9 | NP | 8.8 | none |
9 | 16 | 24 | none | 50 | 2.96 | 1.34 | 1.2 | 26.5 | 24.8 | none | DP | 7.9 | none |
10 | 21 | 31 | mild | none | 5.6 | 0.85 | ≦ 10 | 10 | 22.3 | 14.7 | NP | 9.5 | none |
11 | 27 | 34 | none | none | 5.57 | 0.79 | 0.8 | 1.17 | 24.5 | 16.9 | NP | 7.2 | none |
12 | 31 | 35 | nausea | 50 | 1.73 | 0.9 | 0.45 | <0.50 | 27.6 | 12.6 | NP | 7.8 | none |
13 | 33 | 28 | nausea | 37.5 | 2.31 | 1.11 | 1.96 | <0.50 | 21.3 | 9.3 | NP | 7.1 | none |
low basal serum cortisol but refused stimulation test (n = 2) | |||||||||||||
14 | 19 | 29 | hypoglyceimia | 12.5 | 1.8 | 1.08 | 11.5 | 0.61 | 13.4 | 6.3 | NP | 8.1 | NA |
15 | 31 | 34 | nausea | 100 | 0.59 | 1.13 | 88 | 281 | 16.8 | none | NP | 9.7 | none |
The incidence of newly diagnosed AI, comparison of baseline characteristics
Group 1 | Group 2 | Group 3 | P-value | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total | Early | Mid | Total | Early | Total | Early | Mid | Late | 1 vs 2* | 1 vs 3* | |
Cases, n | 4 | 3 | 1 | 3 | 3 | 6 | 1 | 3 | 2 | ||
Variables | |||||||||||
Pregnacy, weeks | 14.3 ± 2.5 | 13.3 ± 2.1 | 17 | 11.3 ± 4 | 23.7 ± 7.9 | 14 | 21.3 ± 5.5 | 32 ± 1.4 | n. s. | n. s. | |
Age, yr | 35.0 ± 4.8 | 36.3 ± 4.9 | 31 | 30.0 ± 7.5 | 32.2 ± 5.9 | 41 | 29.7 ± 5.1 | 31.5 ± 4.9 | n. s. | n. s. | |
BMI, kg/m2 | 27.2 ± 6.9 | 28.2 ± 8.1 | 24.2 | 19.2 ± 2.1 | 23.5 ± 4.0 | 22.8 | 21.5 ± 2.9 | 26.8 ± 5.4 | n. s. | n. s. | |
WBC, ×102/µL | 81.8 ± 16.5 | 80.3 ± 19.9 | 86 | 74.3 ± 19.1 | 80.2 ± 16.4 | 80 | 77 ± 12.2 | 85 ± 31.1 | n. s. | n. s. | |
Eosino, % | 2.9 ± 1.1 | 2.4 ± 0.6 | 4.4 | 1.3 ± 0.9 | 1.0 ± 0.5 | 0.8 | 1.1 ± 0.8 | 1 | 0.0215 | 0.0043 | |
Hb, g/dL | 11.4 ± 0.5 | 11.7 ± 0.3 | 10.8 | 11.5 ± 0.8 | 11.6 ± 0.9 | 11.9 | 11.6 ± 1.4 | 11.6 ± 0.2 | n. s. | n. s. | |
Na, mEq/L | 136.7 ± 1.0 | 136.6 ± 1.2 | 137 | 138 ± 1.0 | 138.3 ± 1.5 | 137 | 138 ± 1.7 | 139.5 ± 0.7 | n. s. | n. s. | |
K, mEq/L | 4.1 ± 0.2 | 4.1 ± 0.2 | 4 | 4.2 ± 0.3 | 3.8 ± 0.3 | 3.8 | 3.5 ± 0.5 | 3.9 ± 0.1 | n. s. | n. s. | |
LDL-C, mg/dL | 106.8 ± 14.0 | 100 ± 7.9 | 127 | 75 ± 29.8 | 128.8 ± 22.2 | 117 | 119.3 ± 9.7 | 149 ± 32.5 | n. s. | n. s. | |
TG, mg/dL | 159.8 ± 62.1 | 130 ± 19.1 | 81 | 108 ± 12.5 | 199.5 ± 70.9 | 336 | 184.7 ± 28.1 | 153.5 ± 4.9 | n. s. | n. s. | |
HbA1c, % | 5.2 ± 0.26 | 5.2 ± 0.3 | 4.9 | 5.2 ± 0.3 | 5.4 ± 0.3 | 5.7 | 5.2 | 5.5 ± 0.4 | n. s. | n. s. | |
TSH, µIU/mL | 2.4 ± 1.8 | 2.98 ± 1.7 | 0.81 | 5.9 ± 4.8 | 3.2 ± 1.9 | 1.2 | 4.7 ± 1.5 | 2.0 ± 0.4 | n. s. | n. s. | |
FT4, ng/dL | 1.1 ± 0.2 | 1.1 ± 0.3 | 1.1 | 1.1 ± 0.1 | 1.0 ± 0.2 | 0.99 | 1.0 ± 0.3 | 1.0 ± 0.1 | n. s. | n. s. | |
TgAb, U/mL | 7.6 (2.2, 36.7) | 10 (1.2, 45.6) | 5.1 | 92.97 (2.9, 183) | 1.1 (0.7, 4.0) | 0.78 | 1.3 (0.8, 10) | 1.2 (0.5, 2.0) | n. s. | n. s. | |
TPOAb, U/mL | 3.14 (0.7, 12.3) | 5 (1.3, 14.7) | 0.5 | 12.4 (0.5,1450) | 0.8 (0.5, 3.4) | 0.5 | 1.2 (1.2, 10) | 0.5 | n. s. | n. s. | |
ACTH, µg/dL | 17.9 ± 10.0 | 19.0 ± 12 | 14.8 | 13.4 ± 4.8 | 14.6 ± 5.9 | 9 | 18.8 ± 5.3 | 26.8 ± 5.4 | n. s. | n. s. | |
TUS | |||||||||||
diffuse thyroid parenchyma, n (%) | 2(50) | 1(33.3) | 1(100) | 1(33.3) | 1(16.7) | 0(0) | 1(33.3) | 0(0) | n. s. | n. s. | |
Estimated weight, g | 13.3 ± 14.5 | 20.1 ± 19.1 | 13.1 | 11.3 ± 7.9 | 8.0 ± 0.9 | 8.8 | 8.2 ± 1.2 | 7.4 ± 0.4 | n. s. | n. s. |
Pregnancy outcome after replacement therapy
AI (n = 2) | HT (n = 4) | P-value* | |
---|---|---|---|
Gestational age (wk) | 38.5 ± 0.70 | 40.3 ± 1.0 | n. s. |
Mode of delivery | 0.067 | ||
ND, n (%) | 0 (0) | 4 (100) | |
CS, n (%) | 0 (0) | 0 (0) | |
ECS, n (%) | 2 (100) | 0 (0) | |
Male gender, n (%) | 1 (50) | 2 (50) | n. s. |
Birth weight (g) | 2530.5 ± 120.9 | 3038.8 ± 350.3 | n. s. |
Birth height (cm) | 46.7 ± 1.9 | 48.9 ± 2.0 | n. s. |
1-min Apgar | 8.0 | 8.8 ± 0.5 | n. s. |
5-min Apgar | 9.0 | 9.5 ± 0.6 | n. s. |
Placenta weight (g) | 472.0 ± 82.0 | 580.0 ± 88.3 | n. s. |