title: Gestation-specific thyroxine and thyroid stimulating hormone levels in the United States and worldwide.
abstract: BACKGROUND
  Euthyroid women experience dramatic changes in the demand for thyroid hormone production as early as the first trimester of pregnancy. These changes are important for fetal neurodevelopment and organ development as well as maternal health and succesful full term pregnancy. Therefore, gestation-specific reference intervals assist in appropriate clinical management of thyroid disease in pregnancy to ensure maternal and fetal health.
  
  
  OBJECTIVE
  To determine trimester-specific levels of serum thyroxine (T4) and thyroid stimulating hormone (TSH) in the U.S. population based on the National Health and Nutrition Survey III and compare these with published trimester-specific T4 and TSH means and medians obtained in other countries worldwide.
  
  
  METHODS
  Trimester-specific means and medians for T4 and TSH were determined for the U.S. population based on the National Health and Nutrition Survey III database (1988-1994). These were compared with trimester-specific means and medians of other countries in the published literature.
  
  
  RESULTS
  Mean serum T4 levels for the U.S. population were 141.35, 152.95, and 142.65 nmol/L in the three trimesters, respectively, whereas mean serum TSH levels were 0.91, 1.03, and 1.32 mIU/L.
  
  
  CONCLUSIONS
  Gestation-specific mean T4 and TSH levels for the representative U.S. population are well within the trimester-specific reference intervals. T4 and TSH measured during pregnancy in longitudinal and cross-sectional studies of populations worldwide demonstrate that, in some populations, T4 and TSH levels are outside the normal trimester-specific reference intervals.
authors: Department of Oncology, Center for Sex Differences, Washington, DC, USA. os35@georgetown.edu
authors: Offie P
authors: OP
authors: Soldin
authors: Danielle
authors: D
authors: Soldin
authors: Marisol
authors: M
authors: Sastoque
mesh_terms: D005260:Female; D006801:Humans; D009749:Nutrition Surveys; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000097:blood*; D012016:Reference Values; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D014481:United States
chemical_list: D013972:Thyrotropin; D013974:Thyroxine