Thyroid function in human pregnancy: I. The significance of serum butanol-extractable iodines in the last trimester

doi:10.1016/0002-9378(64)90804-X

American Journal of Obstetrics and Gynecology

Volume 90, Issue 4, 15 October 1964, Pages 474-481

https://doi.org/10.1016/0002-9378(64)90804-X Get rights and content

Abstract

Thirty euthyroid women between the inclusive ages of 18 through 34 years exhibited during the first trimester serum BEI's increased above nonpregnant concentrations and maintained at plateau elevations until delivery. Elevations were similar to those for a different population in New Haven, Connecticut. For both euthyroid series serum BEI's, except for sporadic determinations with a few BEI's as high as 10.4, were between 5.5 and 9.5 μg per 100 ml.

Fourteen women, with 11 in the same age range as the 30 controls, failed to follow a plateau elevated pattern of serum BEI's during pregnancy. Eleven of these 14 women with serum BEI's below or above the normal range before the third trimester had normal BEI's for pregnancy near delivery. These data demonstrate that thyroid function during pregnancy can not be evaluated by a single thyroid function test during the last trimester. In spite of the usual plateau elevation of serum PBI or BEI several thyroid function tests, at different stages of pregnancy, are requisite for diagnosis of maternal thyroid function throughout gestation.

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Thyroid function in human pregnancy. IX. Development or retardation of 7-year-old progeny of hypothyroxinemic women
1976, American Journal of Obstetrics and Gynecology
Progeny of women, whose thyroid function was studied gestationally, had psychological and/or neurologic examinations at 8 months, 4 years and 7 years of age. In more than 100 pregnancies (at least 3 per cent of total pregnancies) hypothyroxinemia occurred and was treated adequately or inadequately. Children were delivered after uncomplicated pregnancies (except hypothyroxinemia), had birth weights of at least 2,500 grams, and were excluded when postnatal insults intervened. At 8 months and 4 years progeny of inadequately treated hypothyroxinemic women had the lowest psychological scores. Now 246 7-year-old children have been examined psychologically and neurologically (earlier data on only 101). Definite trends and a few statistically lower psychological scores of progeny of inadequately treated hypothyroxinemic pregnant women are compared with better psychological scores of 7-year-old children born to euthyroid and adequately treated hypothyroxinemic women. In six sibling sets outcome was better when hypothyroxinemic women were treated with adequate thyroid replacement therapy. If a woman has a poor reproductive history, early in a subsequent gestation, thyroid status should be examined and adequate thyroid medication considered seriously.
Thyroid disease in pregnancy
1975, American Journal of Obstetrics and Gynecology
It is frequently difficult to establish a diagnosis of hyperthyroidism in association with pregnancy. Signs and symptoms suggestive of hyperthyroidism may occur in normal pregnancy. Moreover, tests to rule out hyperthyroidism under these conditions are not readily available. Mild hyperthyroidism is not a hazard to an otherwise normal pregnancy and does not require therapy on the basis of this presumption. Hyperthyroidism of a clinically significant degree is safely treatable by medical means without hazard to the fetus. Hyperthyroidism is an uncommon cause for the failure of pregnancy to proceed to term. Treatment with thyroid based on a presumption of this diagnosis is justified, but such patients should be studied carefully after delivery to establish the true state of thyroid function for the future. Other conditions of thyroid dysfunction, including thyroiditis, thyroid carcinoma, nontoxic goiter, and ovarian struma rarely interfere with an otherwise normal pregnancy.
Thyroid function in human pregnancy. VIII. Retardation of progeny aged 7 years; relationships to maternal age and maternal thyroid function
1971, American Journal of Obstetrics and Gynecology
Of 1,394 prenatal patients, 356 registered early and were euthyroid continuously with uncomplicated pregnancies and deliveries of single neonates weighing at least 2,500 grams; 131 others were hypothyroxinemic during uncomplicated pregnancies. For euthyroid mothers, 227 progeny, age 4, and 57, age 7 years, had standard psychological examinations of the Collaborative Study of the National Institute of Neurological Diseases and Stroke. At 4 years, 55 children born to girls age 15 to 17 and 33 children born to women over 35 had significantly lower mean Intelligence Quotients than 18 children born to mothers age 23 and 24. At 7 years, 19 children born to girls age 15 to 17 and 9 children born to women over 35 had significantly lower scores than 10 progeny of women age 25 to 34. Compared to progeny of euthyroid women, lower scores of 4-year-old children of hypothyroxinemic, untreated mothers have been described. At 7 years, 4 of 11 (36 per cent) progeny of hypothyroxinemic, untreated women scored in the dull normal range or below, compared to only 9 of 57 (16 per cent) of children of euthyroid mothers.
Thyroid function in human pregnancy. VII. Development and retardation of 4-year-old progeny of euthyroid and of hypothyroxinemic women
1971, American Journal of Obstetrics and Gynecology
A high incidence of mental retardation occurs in severe endemic goiter areas, but investigations have failed to relate development and retardation of children to maternal gestational hypothyroidism. In Providence, Rhode Island, at age 4 years, 17 children born to hypothyroxinemic women taking adequate thyroid replacement therapy during pregnancy and 27 born to hypothyroxinemic women receiving inadequate thyroid therapy were compared in development with 192 children born to euthyroid women. On the Revised Stanford-Binet (1960) intelligence test in fine motor tests and in speech, children born to euthyroid women aged 15 to 17 and 35 to 43 years scored lower than progeny of 24-year-old women; children of hypothyroxinemic women taking inadequate thyroid replacement therapy scored lower than progeny of euthyroid or hypothyroxinemic women taking adequate thyroid therapy. Thyroid replacement therapy for hypothyroxinemic pregnant women may be significant in mental and fine motor development of progeny.
Hypothyroidism and hashimoto’s thyroiditis: Mechanisms, diagnosis, neuropsychological phenotypes, and treatments
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^☆: This investigation was supported by Public Health Service Research Grant AM 04890-02 from the National Institute of Arthritis and Metabolic Diseases but is now supported by transfer to Grant HD 00415-03 from the National Institute of Child Health and Human Development.

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American Journal of Obstetrics and Gynecology

Thyroid function in human pregnancy: I. The significance of serum butanol-extractable iodines in the last trimester☆

Abstract

Am. J. Obst. & Gynec

Obst. & Gynec. Surv

Yale J. Biol. Med

J. Clin. Endocrinol

J. Lab. & Clin. Med

Obst. & Gynec

New England J. Med

New England J. Med

New England J. Med

New England J. Med

New England J. Med

Obst. & Gynec

J. Clin. Invest

J. Clin. Invest

Thyroid function in human pregnancy. IX. Development or retardation of 7-year-old progeny of hypothyroxinemic women

Thyroid disease in pregnancy

Thyroid function in human pregnancy. VIII. Retardation of progeny aged 7 years; relationships to maternal age and maternal thyroid function

Thyroid function in human pregnancy. VII. Development and retardation of 4-year-old progeny of euthyroid and of hypothyroxinemic women

Hypothyroidism and hashimoto’s thyroiditis: Mechanisms, diagnosis, neuropsychological phenotypes, and treatments

Evelyn B. Man (1904-1992), maternal hypothyroidism and childhood development