title: Maternal thyrotropin is independently related to small for gestational age neonates at term.
abstract: OBJECTIVE
  Small for gestational age (SGA) newborns constitute still a major cause of perinatal morbidity and mortality. Overt thyroid disease is a known cause of preterm birth and low birthweight but in its untreated condition it is rare today. In this study, we investigated the possible relation between maternal thyroid function assessed in euthyroid women at each trimester and the incidence of term born SGA neonates.
  
  
  METHODS
  A prospective cohort study was performed.
  
  
  METHODS
  Thyroid function was assessed at 12, 24 and 36 weeks gestation in 1051 healthy Caucasian women who delivered at ≥ 37 weeks gestation.
  
  
  METHODS
  One-way anova was used to compare mean TSH and FT4 levels between women with SGA neonates and controls. Multiple logistic regression analysis was performed to adjust for known risk factors of SGA.
  
  
  RESULTS
  Seventy (6·7%) SGA neonates were identified and they were significantly more often born to women with a TSH ≥ 97·5th at first and third trimester. Multiple logistic regression analysis showed that smoking (OR: 4·4, 95% CI: 2·49-7·64), pre-eclampsia (OR: 2·8, 95% CI: 1·19-6·78) and TSH ≥ 97·5th percentile (OR 3·3, 95% CI 1·39-7·53) were significantly related to SGA. Maternal FT4 levels and TPO-Ab status were not associated with SGA offspring.
  
  
  CONCLUSIONS
  Our data show that TSH levels in the upper range of the reference interval at different trimesters (3·0-3·29 mIU/l) are independently related to an increased risk of delivering SGA neonates at term.
authors.affiliation: Department of Obstetrics and Gynaecology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Medical Health Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Monen
authors.forename: S M
authors.initials: SM
authors.lastname: Kuppens
authors.forename: T H
authors.initials: TH
authors.lastname: Hasaart
authors.forename: H P
authors.initials: HP
authors.lastname: Oosterbaan
authors.forename: S G
authors.initials: SG
authors.lastname: Oei
authors.forename: H
authors.initials: H
authors.lastname: Wijnen
authors.forename: E K
authors.initials: EK
authors.lastname: Hutton
authors.forename: H L
authors.initials: HL
authors.lastname: Vader
authors.forename: V J
authors.initials: VJ
authors.lastname: Pop
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood; D011247:Pregnancy; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters / Q000097:blood; D047929:Term Birth / Q000097:blood; D013972:Thyrotropin / Q000097:blood*
chemical_list: D013972:Thyrotropin