Determination of Thyroid Dysfunction and Reference Intervals during the third trimester in Port Harcourt, Nigeria

Authors

  • Ehimen Phyllis Odum University of Port Harcourt and University of Port Harcourt Teaching Hospital
  • Ochuko Otokunefor University of Port Harcourt and University of Port Harcourt Teaching Hospital

DOI:

https://doi.org/10.60787/tnhj.v17i3.304

Keywords:

prevalence, thyroid disorders, reference intervals, pregnant women, third trimester

Abstract

Background: Prevalence of thyroid disorders in pregnancy varies with reference intervals of thyroid function tests among various populations globally, considering differences in population-specific characteristics and geographical locations.

Objective: To determine the prevalence of thyroid disorders in pregnant women in the third trimester in an iodine-sufficient city using internationally-recommended, assay-specific and laboratory-derived reference limits and to determine third trimester-specific reference intervals for thyroid function tests.

Subjects and Methods: Serum thyrotropin (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were analysed in 178 pregnant women. Thyroid disorders were defined according to three criteria: the American Thyroid Association (ATA) third trimester-reference ranges, assay-specific non-pregnant reference intervals and laboratory-derived third trimester-reference intervals for thyroid function tests.

Results: Using the ATA criteria, overall prevalence of thyroid disorders was 18.0%: subclinical hypothyroidism (12.4%), overt hypothyroidism (3.4%), overt hyperthyroidism (1.1%) and isolated hypothyroxinemia (1.1%). Using the assay-specific reference intervals, overall prevalence of thyroid disorders was 11.7%: subclinical hypothyroidism (7.3%), overt hypothyroidism (2.2%), overt hyperthyroidism (1.1%) and isolated hypothyroxinemia (1.1%).  Using the laboratory-derived reference intervals, overall prevalence of thyroid disorders was 13.4%: subclinical hypothyroidism (8.4%), overt hypothyroidism (2.8%), overt hyperthyroidism (1.1%) and isolated hypothyroxinemia (1.1%). Laboratory-derived reference intervals for TSH, FT4 and FT3 were 0.40 – 3.70 mIU/L, 8.89 – 18.85 pmol/L and 2.88 – 6.05 pmol/L respectively.

Conclusion: Laboratory-derived lower and upper reference intervals for TSH, FT4 and FT3 were observed to be lower than the assay-specific reference intervals and higher than the ATA third trimester TSH reference intervals.

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Author Biographies

Ehimen Phyllis Odum, University of Port Harcourt and University of Port Harcourt Teaching Hospital

Department of Chemical Pathology, Consultant

Ochuko Otokunefor, University of Port Harcourt and University of Port Harcourt Teaching Hospital

Chemical Pathology; Consultant

References

Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011;21:1081-125.

Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocrine Rev 1997;18:404-33.

Sahay RK, Nagesh VS. Hypothyroidism in pregnancy. Indian J Endocrinol Metab.2012;16:364-70.

Medici M, Korevaar TI, Visser WE, Visser TJ, Peeters RP. Thyroid function in pregnancy: What is normal? Clin Chem 2015;61:704-13.

Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI et al. clinical Practice Guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid 2012;22:1200-35.

Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, Vaidya B. 2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children. Eur Thyroid J 2014;3:76-94.

Stricker Rt, Echenard M, Eberhart R, Chevailler M-C, Perez V, Quinn FA, Stricker Rn. Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals. Eur J Endocrinol 2007;157:509-14.

Nte AR, Ndu N. Salt iodisation in Port Harcourt metropolis: a survey of households and markets. Port Harcourt Med J. 2007;2:27-34.

Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, Cunningham FG. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 2005;105:239-45.

Carney LA, Quinlan JD, West JM. Thyroid disease in pregnancy. Am Fam Physician. 2014;89:273-78.

Laulu SL, Roberts WL. Second-trimester reference intervals for thyroid tests: the role of ethnicity. Clin Chem 2007;53:1-11.

Alkafajei A, Amarin Z, Alazaizeh W, Khader Y, Marji M. Prevalence and risk factors for hypothyroidism in Jordanian women: comparison between different reference ranges. East Meditter Health J 2012;18:132-6.

Mbah AU, Ejim EE, Onodugo OD, Ezugwu FO, Eze MI, Nkwo PO, Ugbajah WC. Two logistic models for the prediction of hypothyroidism in pregnancy. BMC Res Notes 2011;4:205-14.

Umenwanne EO, Akinyele IO. Inadequate salt iodization and poor knowledge attitudes and practices regarding iodine-deficiency disorders in an area of endemic goiter in south-eastern Nigeria. Food Nutr Bull 2000;21:311-5.

Chen L-M, Du W-J, Dai J, Zhang Q, Si G-X, Yang H, et al. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: A single-center cohort study of a Chinese population. PLoS ONE 2014;9: e109364.doi: 10.1371/journal.pone.0109364.

Moon H-W, Chung H-J, Park C-M, Hur M, Yun Y-M. Establishment of trimester-specific reference intervals for thyroid hormones in Korean pregnant women. Ann Lab Med 2015;35:198-204.

Sekhri T, Agarwal J, Wilfred R, Kanwar RS, Sethi J, Bhadra K, Nair S, Singh S. Trimester-specific reference intervals for thyroid function tests in normal Indian pregnant women. Indian J Endocrinol Metab 2016;20:101-7.

Mehran L, Amouzegar A, Delshad H, Askari S, Hedayati M, Amirshekari G, Azizi F. Trimester-specific reference ranges for thyroid hormones in Iranian Pregnant Women. J Thyroid Res 2013;2013:651517.

Gesing A, Lewinski A, Karbownik-Lewinska M. The thyroid gland and the process of aging: what is new? Thyroid Research 2012;5:16-20.

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Published

2018-03-04

How to Cite

Odum, E. P., & Otokunefor, O. (2018). Determination of Thyroid Dysfunction and Reference Intervals during the third trimester in Port Harcourt, Nigeria. The Nigerian Health Journal, 17(3), 70–78. https://doi.org/10.60787/tnhj.v17i3.304
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