title: Thyroid function testing in women who had a stillbirth.
abstract: Thyroid dysfunction is thought to be associated with stillbirth. Therefore, thyroid function is often recommended in the diagnostic investigations for stillbirth.
  
  
  
  We aimed to evaluate the added value of thyroid function testing in the diagnostic investigations for stillbirth.
  
  
  
  A nationwide multicentre prospective cohort study in 1025 women who suffered stillbirth >20 weeks of gestation performed between 2002 and 2008. In each woman, an extensive diagnostic work-up was performed, including placental examination and autopsy. TSH and FT4 values below the 2·5th percentile or above the 97·5th percentile according local laboratory reference values were regarded as abnormal. Women with a history of thyroid disease were evaluated separately.
  
  
  
  Thyroid function abnormalities in women with stillbirth.
  
  
  
  Of 1025 included women, 21 had a history of thyroid disease (2%). In the 875 with TSH and FT4 results and no history of thyroid disease, 10% had hypothyroxinemia, 4·6% subclinical hypothyroidism, 1·6% overt hypothyroidism and 1·5% subclinical hyperthyroidism. Women with a subclinical hyperthyroidism more often had a foetal death caused by foetal hydrops: 23% vs 2·9% (adjusted OR 10·3, 95% CI 2·5-42).
  
  
  
  Women with a stillbirth had a slightly higher prevalence of overt hypothyroidism, subclinical hypothyroidism and hypothyroxinaemia compared to previous studies on thyroid dysfunction in pregnant women. Given the absence of a strong associations with the cause of stillbirth, and no demonstrated beneficial effects of treating thyroid dysfunction in these women, routine screening after stillbirth is not justified.
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Janna W
authors.initials: JW
authors.lastname: Nijkamp
authors.affiliation: Department of Obstetrics and Gynecology, Martini Hospital, Groningen, The Netherlands.
authors.forename: Fleurisca J
authors.initials: FJ
authors.lastname: Korteweg
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Groen
authors.affiliation: Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Albertus
authors.initials: A
authors.lastname: Timmer
authors.affiliation: Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Gerrit
authors.initials: G
authors.lastname: Van Den Berg
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Bossuyt
authors.affiliation: The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia.
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Jan Jaap H M
authors.initials: JJ
authors.lastname: Erwich
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006980:Hyperthyroidism; D007037:Hypothyroidism; D009426:Netherlands; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D011446:Prospective Studies; D050497:Stillbirth; D013960:Thyroid Function Tests / Q000706:statistics & numerical data*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D055815:Young Adult
chemical_list: D013972:Thyrotropin; D013974:Thyroxine