Reference Intervals Settting of Thyroid Hormones during Different Phases of Pregnancy among Thyroid Antibody Negative Women in Quanzhou, Fujian_Chinese Journal of Evidence-Based Medicine

Authors：

 MINGDe-song ¹ , HEWei-dong ² ,  ZHAJin-shun ³ , YIQiao-xia ⁴ , YANZhao-ming ⁵

1. Quanzhou Medical College, Quanzhou 362000, China;
2. Department of Laboratory Medicine, Shishi City Maternal and Child Health Care, Shishi 362700, China;
3. Department of Nuclear Medicine, Affiliated Second Hospital, Fujian Medical University, Fuzhou 350000, China;
4. Department of Laboratory Medicine, Anxi City Maternal and Child Health Care, Anxi 362400, China;
5. Department of Laboratory Medicine, Dehua City Maternal and Child Health Care, Dehua 362500, China;

Corresponding author：

ZHAJin-shun, Email: 13107865940@126.com

Keywords：

Pregnancy; Thyroid hormone; Normal reference interval; Quanzhou

DOI：

10.7507/1672-2531.20140153

Video：

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Objective To set reference intervals of the levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies during three trimesters of pregnancy in Quanzhou city, Fujian province. Methods A total of 490 pregnant women during 4-39 week pregnancy without presence of thyroid antibodies were enrolled in Quanzhou city, Fujian province. Levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT₃), free thyroxine (FT₄) and thyroid peroxidase antibodies (TPO-Ab) were detected through the electrochemistry immunoassay (ECL) method. In addition, a total of 51 healthy women without pregnancy were enrolled to set the reference intervals of levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies. Results The median levels of TPO-Ab were in the reference intervals provided by the pharmaceutical factory. Levels of FT₃ and FT₄ gradually decreased from the first to the third trimester (P < 0.01), levels of serum TSH gradually increasd from the first to the third trimester (P < 0.01). Compared with those of pregnant women, levels of thyroid hormone in normal non-pregnant women were higher in the first trimester, lower in the second and the third trimesters (P < 0.01). During three trimesters, the reference intervals of FT₃ in the three trimesters were (first: 3.75 to 7.23; second 3.31 to 4.9; and third: 3.16 to 4.48 pmol/L); the reference intervals of FT₄ were (first: 12.85 to 25.3; second: 12.03 to 20.14; and third: 11.02 to 19.43 pmol/L); and the reference intervals of TSH were (first: 0.01 to 3.79; second: 1.09 to 4.19; and third: 1.08 to 5.95 mIU/L), respectively. Conclusion Through this detection, we set the levels of thyroid hormones among normal pregnant women without presence of thyroid antibodies during three trimesters of pregnancy in Quanzhou city.

Citation： MINGDe-song, HEWei-dong, ZHAJin-shun, YIQiao-xia, YANZhao-ming. Reference Intervals Settting of Thyroid Hormones during Different Phases of Pregnancy among Thyroid Antibody Negative Women in Quanzhou, Fujian. Chinese Journal of Evidence-Based Medicine, 2014, 14(8): 919-922. doi: 10.7507/1672-2531.20140153 Copy

1.	许红, 何红美, 高虹, 等.石家庄地区正常孕妇妊娠期甲状腺功能变化研究.中国优生与遗传杂志, 2011, 19(10): 94-95.
2.	曾张琴, 蒙杰.妊娠早、中期孕妇甲状腺功能变化特点的研究.国际检验医学杂志, 2013, 34(20): 2777-2778.
3.	王晓兰, 李艳, 马孝甜, 等.孕前及孕期甲状腺功能减退筛查的临床分析.中国优生与遗传杂志, 2012, 20(3): 67-68.
4.	苑春华, 刘晓华, 苑慧.妊娠期甲状腺功能亢进围产结局的临床观察.中国妇幼保健, 2010, 25(9): 1303-1304.
5.	劳丹华, 潘志坚, 黄剑娴, 等.妊娠合并甲状腺功能亢进症不同控制状态对母婴的影响.中国慢性病预防与控制, 2012, 20(1): 57-59.
6.	李力, 颜耀华.妊娠合并甲状腺功能减退症对妊娠结局影响.中国实用妇科与产科杂志, 2013, 29(6): 423-425.
7.	肖海群, 王新.甲状腺功能减退对妊娠及其结局的影响.中国现代医学杂志, 2012, 22(18): 53-56.
8.	刘赛, 张弛, 李华珠, 等.妊娠晚期亚临床甲减及TPO-Ab对妊娠结局的影响.湖南师范大学学报(医学版), 2013, 10(2): 23-25.
9.	马瑛, 武建利, 李芳.妊娠合并亚临床甲状腺功能减退46例妊娠结局分析.新疆医学, 2013, 43(7): 62-64.
10.	刘小莲, 邱文, 梁秋波, 等.妊娠早中期妇女亚临床甲状腺功能异常对后代甲状腺功能和智力及身体发育的影响.中国全科医学, 2012, 15(15): 1698-1700.
11.	战同霞, 谢海, 张建军, 等.孕妇亚临床甲状腺功能低下对新生儿健康的影响.中国现代医学杂志, 2011, 21(8): 1027-1028, 1031.
12.	张淼, 时立新. 2012年中国《妊娠和产后甲状腺疾病诊治指南》解读.中国实用内科杂志, 2012, 32(10): 761-763.
13.	Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid, 2011, 21(10): 1081-1125.
14.	The Endorine Society, AACE, AOTA, et al. Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2007, 92(8): S1-S47.
15.	Dorizzi RM, Ozzola G, Sommella C, et al. An approach to establish reference intervals for thyrotropin in pregnancy using the ADVIA Centaur analyzer. Clin Lab, 2010, 56(9-10): 417-425.
16.	陈秀兰, 赵海波, 赵嵩, 等.不同孕周及产后初期妇女尿碘含量及甲状腺功能指标变化.微循环学杂志, 2012, 22(3): 64-65.
17.	杨丽芬, 杨丹妮, 李维, 等.吉林省不同孕期妇女尿碘水平与甲状腺功能关系的调查.中国地方病防治杂志, 2013, 28(3): 194-195.
18.	Männistö T, Surcel HM, Ruokonen A, et al. Early pregnancy reference intervals of thyroid hormone concentrations in a thyroid antibody-negative pregnant population. Thyroid, 2011, 21(3): 291-298.
19.	于钧, 刘鹏, 申红梅, 等.中国部分沿海地区居民碘营养状况调查结果分析.中国地方病学杂志, 2011, 30(6): 594-597.
20.	李海峰, 梁日初, 刘庆元.正常妊娠早中晚期血清游离甲状腺素水平及参考区间在两种检测系统的比较分析.检验医学与临床, 2012, 9(12): 1480-1481.
21.	张宁, 闫素文, 徐斌, 等.建立地区、孕龄和方法特异性甲状腺激素参考值范围在妊娠期甲状腺功能评价中的作用.中国优生与遗传杂志, 2013, 21(2): 57-59, 83.
22.	Yan YQ, Dong ZL, Dong L, et al. Trimester-and method-specific reference intervals for thyroid tests in pregnant Chinese women: methodology, euthyroid definition and iodine status can influence the setting of reference intervals. Clin Endocrinol (Oxf), 2011, 74(2): 262-269.
23.	Springer D, Zima T, Limanova Z. Reference intervals in evaluation of maternal thyroid function during the first trimester of pregnancy. Eur J Endocrinol, 2009, 160(5): 791-797.
24.	骆展鹏, 邹晓萍, 黎美君, 等. "即刻法"室内质量控制方法学的改进.国际检验医学杂志, 2010, 31(11): 1234-1235.
25.	Lee RH, Spencer CA, Mestman JH, et al. Free T4 immunoassays are flawed during pregnancy. Am J Obstet Gynecol, 2009, 200(1): 260.
26.	Cotzias C, Wong SJ, Taylor E, et al. A study to establish gestation-specific reference intervals for thyroid function tests in normal singleton pregnancy. Eur J Obstet Gynecol Reprod Biol, 2008, 137(1): 61-66.

1. 许红, 何红美, 高虹, 等.石家庄地区正常孕妇妊娠期甲状腺功能变化研究.中国优生与遗传杂志, 2011, 19(10): 94-95.
2. 曾张琴, 蒙杰.妊娠早、中期孕妇甲状腺功能变化特点的研究.国际检验医学杂志, 2013, 34(20): 2777-2778.
3. 王晓兰, 李艳, 马孝甜, 等.孕前及孕期甲状腺功能减退筛查的临床分析.中国优生与遗传杂志, 2012, 20(3): 67-68.
4. 苑春华, 刘晓华, 苑慧.妊娠期甲状腺功能亢进围产结局的临床观察.中国妇幼保健, 2010, 25(9): 1303-1304.
5. 劳丹华, 潘志坚, 黄剑娴, 等.妊娠合并甲状腺功能亢进症不同控制状态对母婴的影响.中国慢性病预防与控制, 2012, 20(1): 57-59.
6. 李力, 颜耀华.妊娠合并甲状腺功能减退症对妊娠结局影响.中国实用妇科与产科杂志, 2013, 29(6): 423-425.
7. 肖海群, 王新.甲状腺功能减退对妊娠及其结局的影响.中国现代医学杂志, 2012, 22(18): 53-56.
8. 刘赛, 张弛, 李华珠, 等.妊娠晚期亚临床甲减及TPO-Ab对妊娠结局的影响.湖南师范大学学报(医学版), 2013, 10(2): 23-25.
9. 马瑛, 武建利, 李芳.妊娠合并亚临床甲状腺功能减退46例妊娠结局分析.新疆医学, 2013, 43(7): 62-64.
10. 刘小莲, 邱文, 梁秋波, 等.妊娠早中期妇女亚临床甲状腺功能异常对后代甲状腺功能和智力及身体发育的影响.中国全科医学, 2012, 15(15): 1698-1700.
11. 战同霞, 谢海, 张建军, 等.孕妇亚临床甲状腺功能低下对新生儿健康的影响.中国现代医学杂志, 2011, 21(8): 1027-1028, 1031.
12. 张淼, 时立新. 2012年中国《妊娠和产后甲状腺疾病诊治指南》解读.中国实用内科杂志, 2012, 32(10): 761-763.
13. Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid, 2011, 21(10): 1081-1125.
14. The Endorine Society, AACE, AOTA, et al. Management of Thyroid Dysfunction during Pregnancy and Postpartum: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, 2007, 92(8): S1-S47.
15. Dorizzi RM, Ozzola G, Sommella C, et al. An approach to establish reference intervals for thyrotropin in pregnancy using the ADVIA Centaur analyzer. Clin Lab, 2010, 56(9-10): 417-425.
16. 陈秀兰, 赵海波, 赵嵩, 等.不同孕周及产后初期妇女尿碘含量及甲状腺功能指标变化.微循环学杂志, 2012, 22(3): 64-65.
17. 杨丽芬, 杨丹妮, 李维, 等.吉林省不同孕期妇女尿碘水平与甲状腺功能关系的调查.中国地方病防治杂志, 2013, 28(3): 194-195.
18. Männistö T, Surcel HM, Ruokonen A, et al. Early pregnancy reference intervals of thyroid hormone concentrations in a thyroid antibody-negative pregnant population. Thyroid, 2011, 21(3): 291-298.
19. 于钧, 刘鹏, 申红梅, 等.中国部分沿海地区居民碘营养状况调查结果分析.中国地方病学杂志, 2011, 30(6): 594-597.
20. 李海峰, 梁日初, 刘庆元.正常妊娠早中晚期血清游离甲状腺素水平及参考区间在两种检测系统的比较分析.检验医学与临床, 2012, 9(12): 1480-1481.
21. 张宁, 闫素文, 徐斌, 等.建立地区、孕龄和方法特异性甲状腺激素参考值范围在妊娠期甲状腺功能评价中的作用.中国优生与遗传杂志, 2013, 21(2): 57-59, 83.
22. Yan YQ, Dong ZL, Dong L, et al. Trimester-and method-specific reference intervals for thyroid tests in pregnant Chinese women: methodology, euthyroid definition and iodine status can influence the setting of reference intervals. Clin Endocrinol (Oxf), 2011, 74(2): 262-269.
23. Springer D, Zima T, Limanova Z. Reference intervals in evaluation of maternal thyroid function during the first trimester of pregnancy. Eur J Endocrinol, 2009, 160(5): 791-797.
24. 骆展鹏, 邹晓萍, 黎美君, 等. "即刻法"室内质量控制方法学的改进.国际检验医学杂志, 2010, 31(11): 1234-1235.
25. Lee RH, Spencer CA, Mestman JH, et al. Free T4 immunoassays are flawed during pregnancy. Am J Obstet Gynecol, 2009, 200(1): 260.
26. Cotzias C, Wong SJ, Taylor E, et al. A study to establish gestation-specific reference intervals for thyroid function tests in normal singleton pregnancy. Eur J Obstet Gynecol Reprod Biol, 2008, 137(1): 61-66.

Chinese Journal of Evidence-Based Medicine

Reference Intervals Settting of Thyroid Hormones during Different Phases of Pregnancy among Thyroid Antibody Negative Women in Quanzhou, Fujian

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