title: Transient hypothyroxinemia in severe hypertensive disorders of pregnancy.
abstract: OBJECTIVE
  Assess whether and to what extent thyroid function is affected in pregnant women with early and severe hypertensive disorders and in their newborns.
  
  
  METHODS
  Patients were 80 women with preeclampsia, hemolysis, elevated liver enzymes, and low platelet count syndrome or gestational hypertension combined with fetal growth restriction in the 24th to 34th week of singleton pregnancies. Maternal thyroid hormone levels and thyroid peroxidase antibodies were determined at admission and 3 months postpartum. Neonatal levels were determined from cord blood at delivery. Maternal hypothyroxinemia was defined as free T(4) (fT(4)) value below 9 pM.
  
  
  RESULTS
  At admission 26 (33%) women in the study group had fT(4) levels below 9 pM, with spontaneous normalization during pregnancy. There were no statistically significant differences between thyroid hormone values in women in the study group and 10 normotensive pregnant women in their third trimester. Three months postpartum, 97.5% of patients had normal thyroid hormone levels. Thyroid peroxidase antibodies were elevated in 10% of women postpartum. Their infants, born at a median gestational age of 30 6/7 weeks, had lower cord blood fT(4) and thyroid-stimulating hormone values compared with preterm infants of the comparison group, appropriate for gestational age. Cord blood fT(4) had no correlation with gestational age or maternal fT(4), but there was a significant correlation of cord blood fT(4) with umbilical artery pH.
  
  
  CONCLUSIONS
  Women with severe hypertensive disorders of pregnancy may have transiently lower fT(4) levels, without evidence of a thyroid disorder. Their neonates have lower fT(4) levels at birth unrelated to maternal fT(4), but related to prenatal acidosis.
  
  
  METHODS
  II-2.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, 1100 DD Amsterdam, the Netherlands. m.buimer@amc.uwa.nl
authors.forename: Maarten
authors.initials: M
authors.lastname: Buimer
authors.forename: Aleid G
authors.initials: AG
authors.lastname: van Wassenaer
authors.forename: Wessel
authors.initials: W
authors.lastname: Ganzevoort
authors.forename: Hans
authors.initials: H
authors.lastname: Wolf
authors.forename: Otto P
authors.initials: OP
authors.lastname: Bleker
authors.forename: Joke H
authors.initials: JH
authors.lastname: Kok
mesh_terms: D000328:Adult; D015551:Autoimmunity / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood* / Q000276:immunology; D007231:Infant, Newborn; D007453:Iodide Peroxidase / Q000097:blood; D049590:Postpartum Period / Q000097:blood; D011247:Pregnancy; D013961:Thyroid Gland / Q000503:physiopathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood*; D013975:Thyroxine-Binding Proteins / Q000378:metabolism; D014284:Triiodothyronine / Q000097:blood; D014285:Triiodothyronine, Reverse / Q000097:blood
chemical_list: D013975:Thyroxine-Binding Proteins; D014284:Triiodothyronine; D014285:Triiodothyronine, Reverse; D013972:Thyrotropin; D007453:Iodide Peroxidase; D013974:Thyroxine