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Serum TSH determinations in pregnancy: how, when and why?

Nature Reviews Endocrinology volume 6, pages 526–529 (2010)Cite this article

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Abstract

Improvements in the sensitivity of the serum TSH assay have revolutionized our strategies for investigating thyroid function and firmly established TSH as the first-line thyroid function test for most clinical situations, including pregnancy. As a single hormone determination, serum TSH provides the most sensitive index to reliably detect thyroid function abnormalities. Normal thyroid function is important to ensure the best possible pregnancy outcome; in addition, disorders of the thyroid gland are relatively frequent in women of childbearing age. The aim of this article is, therefore, to present relevant information on analytical, as well as clinical, aspects regarding serum TSH determination and its usefulness to detect subtle thyroid function abnormalities associated with the pregnant state, namely overt and subclinical hypothyroidism and hyperthyroidism. As these disorders are associated with poor pregnancy outcome, the authors of the present article are in favor of serum TSH measurement for all pregnant women.

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Figure 1: TSH changes during pregnancy.
Figure 2: Algorithm for the detection of thyroid dysfunction in pregnancy based on initial serum TSH determination.

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Authors and Affiliations

  1. Department of Internal Medicine, University Hospital Saint-Pierre, Université Libre de Bruxelles, Rue Haute 322, B-1000, Brussels, Belgium

    Daniel Glinoer

  2. Department of Medicine, Keck School of Medicine, University of Southern California, 2025 Zonal Avenue, Los Angeles, 90032, CA, USA

    Carole A. Spencer

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  1. Daniel Glinoer
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  2. Carole A. Spencer
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Contributions

D. Glinoer and C. A. Spencer researched the data for the article. D. Glinoer and C. A. Spencer provided a substantial contribution to discussions of the content. D. Glinoer and C. A. Spencer contributed equally to writing the article and to review and/or editing of the manuscript before submission.

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Correspondence to Daniel Glinoer.

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The authors declare no competing financial interests.

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Glinoer, D., Spencer, C. Serum TSH determinations in pregnancy: how, when and why?. Nat Rev Endocrinol 6, 526–529 (2010). https://doi.org/10.1038/nrendo.2010.91

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