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.	?許紅, 何紅美, 高虹, 等.石家莊地區正常孕婦妊娠期甲狀腺功能變化研究.中國優生與遺傳雜志, 2011, 19(10): 94-95.
2.	曾張琴, 蒙杰.妊娠早、中期孕婦甲狀腺功能變化特點的研究.國際檢驗醫學雜志, 2013, 34(20): 2777-2778.
3.	王曉蘭, 李艷, 馬孝甜, 等.孕前及孕期甲狀腺功能減退篩查的臨床分析.中國優生與遺傳雜志, 2012, 20(3): 67-68.
4.	苑春華, 劉曉華, 苑慧.妊娠期甲狀腺功能亢進圍產結局的臨床觀察.中國婦幼保健, 2010, 25(9): 1303-1304.
5.	勞丹華, 潘志堅, 黃劍嫻, 等.妊娠合并甲狀腺功能亢進癥不同控制狀態對母嬰的影響.中國慢性病預防與控制, 2012, 20(1): 57-59.
6.	李力, 顏耀華.妊娠合并甲狀腺功能減退癥對妊娠結局影響.中國實用婦科與產科雜志, 2013, 29(6): 423-425.
7.	肖海群, 王新.甲狀腺功能減退對妊娠及其結局的影響.中國現代醫學雜志, 2012, 22(18): 53-56.
8.	劉賽, 張弛, 李華珠, 等.妊娠晚期亞臨床甲減及TPO-Ab對妊娠結局的影響.湖南師范大學學報(醫學版), 2013, 10(2): 23-25.
9.	馬瑛, 武建利, 李芳.妊娠合并亞臨床甲狀腺功能減退46例妊娠結局分析.新疆醫學, 2013, 43(7): 62-64.
10.	劉小蓮, 邱文, 梁秋波, 等.妊娠早中期婦女亞臨床甲狀腺功能異常對后代甲狀腺功能和智力及身體發育的影響.中國全科醫學, 2012, 15(15): 1698-1700.
11.	戰同霞, 謝海, 張建軍, 等.孕婦亞臨床甲狀腺功能低下對新生兒健康的影響.中國現代醫學雜志, 2011, 21(8): 1027-1028, 1031.
12.	張淼, 時立新. 2012年中國《妊娠和產后甲狀腺疾病診治指南》解讀.中國實用內科雜志, 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.	陳秀蘭, 趙海波, 趙嵩, 等.不同孕周及產后初期婦女尿碘含量及甲狀腺功能指標變化.微循環學雜志, 2012, 22(3): 64-65.
17.	楊麗芬, 楊丹妮, 李維, 等.吉林省不同孕期婦女尿碘水平與甲狀腺功能關系的調查.中國地方病防治雜志, 2013, 28(3): 194-195.
18.	M?nnist? 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.	于鈞, 劉鵬, 申紅梅, 等.中國部分沿海地區居民碘營養狀況調查結果分析.中國地方病學雜志, 2011, 30(6): 594-597.
20.	李海峰, 梁日初, 劉慶元.正常妊娠早中晚期血清游離甲狀腺素水平及參考區間在兩種檢測系統的比較分析.檢驗醫學與臨床, 2012, 9(12): 1480-1481.
21.	張寧, 閆素文, 徐斌, 等.建立地區、孕齡和方法特異性甲狀腺激素參考值范圍在妊娠期甲狀腺功能評價中的作用.中國優生與遺傳雜志, 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.	駱展鵬, 鄒曉萍, 黎美君, 等. "即刻法"室內質量控制方法學的改進.國際檢驗醫學雜志, 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. ?許紅, 何紅美, 高虹, 等.石家莊地區正常孕婦妊娠期甲狀腺功能變化研究.中國優生與遺傳雜志, 2011, 19(10): 94-95.
2. 曾張琴, 蒙杰.妊娠早、中期孕婦甲狀腺功能變化特點的研究.國際檢驗醫學雜志, 2013, 34(20): 2777-2778.
3. 王曉蘭, 李艷, 馬孝甜, 等.孕前及孕期甲狀腺功能減退篩查的臨床分析.中國優生與遺傳雜志, 2012, 20(3): 67-68.
4. 苑春華, 劉曉華, 苑慧.妊娠期甲狀腺功能亢進圍產結局的臨床觀察.中國婦幼保健, 2010, 25(9): 1303-1304.
5. 勞丹華, 潘志堅, 黃劍嫻, 等.妊娠合并甲狀腺功能亢進癥不同控制狀態對母嬰的影響.中國慢性病預防與控制, 2012, 20(1): 57-59.
6. 李力, 顏耀華.妊娠合并甲狀腺功能減退癥對妊娠結局影響.中國實用婦科與產科雜志, 2013, 29(6): 423-425.
7. 肖海群, 王新.甲狀腺功能減退對妊娠及其結局的影響.中國現代醫學雜志, 2012, 22(18): 53-56.
8. 劉賽, 張弛, 李華珠, 等.妊娠晚期亞臨床甲減及TPO-Ab對妊娠結局的影響.湖南師范大學學報(醫學版), 2013, 10(2): 23-25.
9. 馬瑛, 武建利, 李芳.妊娠合并亞臨床甲狀腺功能減退46例妊娠結局分析.新疆醫學, 2013, 43(7): 62-64.
10. 劉小蓮, 邱文, 梁秋波, 等.妊娠早中期婦女亞臨床甲狀腺功能異常對后代甲狀腺功能和智力及身體發育的影響.中國全科醫學, 2012, 15(15): 1698-1700.
11. 戰同霞, 謝海, 張建軍, 等.孕婦亞臨床甲狀腺功能低下對新生兒健康的影響.中國現代醫學雜志, 2011, 21(8): 1027-1028, 1031.
12. 張淼, 時立新. 2012年中國《妊娠和產后甲狀腺疾病診治指南》解讀.中國實用內科雜志, 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. 陳秀蘭, 趙海波, 趙嵩, 等.不同孕周及產后初期婦女尿碘含量及甲狀腺功能指標變化.微循環學雜志, 2012, 22(3): 64-65.
17. 楊麗芬, 楊丹妮, 李維, 等.吉林省不同孕期婦女尿碘水平與甲狀腺功能關系的調查.中國地方病防治雜志, 2013, 28(3): 194-195.
18. M?nnist? 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. 于鈞, 劉鵬, 申紅梅, 等.中國部分沿海地區居民碘營養狀況調查結果分析.中國地方病學雜志, 2011, 30(6): 594-597.
20. 李海峰, 梁日初, 劉慶元.正常妊娠早中晚期血清游離甲狀腺素水平及參考區間在兩種檢測系統的比較分析.檢驗醫學與臨床, 2012, 9(12): 1480-1481.
21. 張寧, 閆素文, 徐斌, 等.建立地區、孕齡和方法特異性甲狀腺激素參考值范圍在妊娠期甲狀腺功能評價中的作用.中國優生與遺傳雜志, 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. 駱展鵬, 鄒曉萍, 黎美君, 等. "即刻法"室內質量控制方法學的改進.國際檢驗醫學雜志, 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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