Thyroid-stimulating Hormone (TSH) and Free Thyroxine (FT4) Reference Interval Recommendations and Prevalence of Gestational Thyroid Dysfunction: Quantification of Current Diagnostic Approaches
Authors' conclusion
Alternative approaches to define RIs for TSH and FT4 in pregnancy result in considerable overdiagnosis and underdiagnosis compared with population- and trimester-specific RIs. Additional strategies need to be explored to optimize identification of thyroid dysfunction during pregnancy.
Study context
- Population
- Pregnant women in cohorts of the Consortium on Thyroid and Pregnancy
- Participants
- 52,496 women18 cohorts
- Comparison
- Alternative TSH/FT4 reference interval approaches vs population- and trimester-specific reference intervals (RIs)
- Outcome
- Sensitivity and false discovery rate (FDR) for women with a levothyroxine treatment indication or for whom treatment would be considered per international guidelines
Methodological detailsmulticohort, Consortium on Thyroid and Pregnancy
- Multicohort
- Consortium on Thyroid and Pregnancy
Performance
As reported in the abstract
Detection of treatment indication or consideration
Sensitivity of alternative approaches vs trimester-specific RIs
0.63-0.82
False discovery rate (FDR) of alternative approaches vs trimester-specific RIs
0.11-0.35
Further findings
| Outcome | Fixed limit approach | Subtraction approach | Nonpregnancy RIs |
|---|---|---|---|
| Treatment indication, first trimester: sensitivity-FDR | 0.77-0.11 | 0.74-0.16 | 0.60-0.11 |
Treatment indication, first trimester: sensitivity-FDR
- Sensitivity and FDR similar between fixed limit, subtraction and nonpregnancy approaches
Diagnostic performance by type of thyroid dysfunction
- Performance for overt hypothyroidism, isolated hypothyroxinemia and (sub)clinical hyperthyroidism mainly varied between FT4 RI approaches
- Performance for subclinical hypothyroidism varied between TSH RI approaches
Original publication
TSH and FT4 Reference Interval Recommendations and Prevalence of Gestational Thyroid Dysfunction: Quantification of Current Diagnostic Approaches. J Clin Endocrinol Metab. Published 22 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →