Imperial College London
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ProfessorGrahamWilliams

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Professor of Endocrinology
 
 
 
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Contact

 

+44 (0)20 3313 1383graham.williams

 
 
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Location

 

10N5Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Pop:2018:10.1210/jc.2017-02556,
author = {Pop, V and Broeren, M and Wijnen, H and Endendijk, J and van, Baar A and Wiersinga, W and Williams, GR},
doi = {10.1210/jc.2017-02556},
journal = {The Journal of Clinical Endocrinology & Metabolism},
pages = {2889--2900},
title = {Longitudinal Trajectories of Gestational Thyroid Function: A New Approach to Better Understand Changes in Thyroid Function},
url = {http://dx.doi.org/10.1210/jc.2017-02556},
volume = {103},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - ContextMost studies of thyroid function changes during pregnancy use a cross-sectional design comparing means between groups rather than similarities within groups.ObjectiveLatent class growth analysis (LCGA) is a novel approach to investigate longitudinal changes that provide dynamic understanding of the relationship between thyroid status and advancing pregnancy.DesignProspective observational study with repeated assessments.SettingGeneral community.PatientsEleven hundred healthy women were included at 12 weeks’ gestation.Main Outcome MeasuresThe existence of both free T4 (fT4) and TSH trajectories throughout pregnancy determined by LCGA.ResultsLCGA revealed three trajectory classes. Class 1 (n = 1019; 92.4%), a low increasing TSH reference group, had a gradual increase in TSH throughout gestation (from 1.1 to 1.3 IU/L). Class 2 (n = 30; 2.8%), a high increasing TSH group, displayed the largest increase in TSH (from 1.9 to 3.3 IU/L). Class 3 (n = 51; 4.6%), a decreasing TSH group, had the largest fall in TSH (from 3.2 to 2.4 IU/L). Subclinical hypothyroidism at 12 weeks occurred in up to 60% of class 3 women and was accompanied by elevated thyroid peroxidase antibodies (TPO-Ab) titers (50%) and a parental history of thyroid dysfunction (23%). In class 2, 70% of women were nulliparous compared with 46% in class 1 and 49% in class 3.ConclusionsLCGA revealed distinct trajectories of longitudinal changes in fT4 and TSH levels during pregnancy in 7.4% of women. These trajectories were correlated with parity and TPO-Ab status and followed patterns that might reflect differences in pregnancy-specific immune tolerance between nulliparous and multiparous women.
AU  - Pop,V
AU  - Broeren,M
AU  - Wijnen,H
AU  - Endendijk,J
AU  - van,Baar A
AU  - Wiersinga,W
AU  - Williams,GR
DO  - 10.1210/jc.2017-02556
EP  - 2900
PY  - 2018///
SN  - 0021-972X
SP  - 2889
TI  - Longitudinal Trajectories of Gestational Thyroid Function: A New Approach to Better Understand Changes in Thyroid Function
T2  - The Journal of Clinical Endocrinology & Metabolism
UR  - http://dx.doi.org/10.1210/jc.2017-02556
UR  - http://hdl.handle.net/10044/1/61565
VL  - 103
ER  -
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