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Year : 2020  |  Volume : 24  |  Issue : 2  |  Page : 160-164

Trimester-specific reference intervals for thyroid function parameters in Indian pregnant women during final phase of transition to iodine sufficiency

1 Department of Endocrinology and Metabolism, I.P.G.M.E & R, Kolkata, West Bengal, India
2 Metabolics, Biocon Limited, Bengaluru, India
3 Department of Biochemistry, KPC Medical College, Jadavpur, Kolkata, West Bengal, India
4 Department of Gynaecology and Obstetrics, I.P.G.M.E and R, Kolkata, West Bengal, India

Correspondence Address:
Sujoy Ghosh
Department of Endocrinology and Metabolism, I.P.G.M.E and R, 244 AJC Bose Road, Kolkata - 700 020, West Bengal
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijem.IJEM_561_19

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Background: Interpretation of thyroid function tests during pregnancy depends on gestational age, method, and population-specific reference intervals. Therefore, there is a worldwide trend to establish trimester-specific levels for different populations. The aim of this study was to establish a trimester-specific reference range for thyroid function parameters during pregnancy in Indian women.Materials and Methods: Thyroid function tests (TSH, FT4, TT4, TT3) of 80, 76, and 73 women at 1st, 2nd, and 3rd trimester, respectively, and 168 nonpregnant women were analyzed after exclusion of low UIC( μg/L) and anti-TPO positivity(>35 IU/ml). Urinary iodine excretion (UIC) was assessed in all. The 2.5th and 97.5th percentile values were used to determine the reference ranges for thyrotropin (TSH), free thyroxine (FT4), total thyroxine (TT4), and total triiodothyronine (TT3) for each trimester of pregnancy. Results: The reference range for TSH for first trimester was 0.19–4.34 μIU/ml, for second trimester 0.46–4.57 μIU/ml, and for third trimester 0.61–4.62 μIU/ml. The reference range during three trimesters for FT4 (ng/dl) was 0.88–1.32, 0.89–1.60, and 0.87–1.54, for total T4 (μg/dl) was 5.9–12.9, 7.4–15.2, and 7.9–14.9. In nonpregnant women, FT4 was 0.83–1.34, total T4 was 5.3–11.8, and TSH was 0.79–4.29. The mean UIC in nonpregnant women was 176 ± 15.7 μg/L suggesting iodine-sufficiency in the cohort. Conclusion: The trimester-specific TSH range in pregnant women in this study is not significantly different from nonpregnant reference range in the final phase of transition to iodine sufficiency in India.

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