title: Trimester specific reference intervals for thyroid function tests in normal Indian pregnant women.
abstract: BACKGROUND
  Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases.
  
  
  OBJECTIVE
  We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester.
  
  
  METHODS
  86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison.
  
  
  METHODS
  Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester.
  
  
  METHODS
  SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis.
  
  
  RESULTS
  The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µIU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester.
  
  
  CONCLUSIONS
  The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles.
authors.affiliation: Division of Endocrinology and Thyroid Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Sekhri
authors.affiliation: Division of Endocrinology and Thyroid Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India; Department of Foods and Nutrition, Division of Endocrine Physiology, Faculty of Family and Community Sciences, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India.
authors.forename: Juhi Agarwal
authors.initials: JA
authors.lastname: Juhi
authors.affiliation: Division of Endocrinology and Thyroid Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India.
authors.forename: Reena
authors.initials: R
authors.lastname: Wilfred
authors.affiliation: Division of Endocrinology and Thyroid Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India.
authors.forename: Ratnesh S
authors.initials: RS
authors.lastname: Kanwar
authors.affiliation: Division of Endocrinology and Thyroid Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Sethi
authors.affiliation: Division of Endocrinology and Thyroid Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India.
authors.forename: Kuntal
authors.initials: K
authors.lastname: Bhadra
authors.affiliation: Department of Foods and Nutrition, Division of Endocrine Physiology, Faculty of Family and Community Sciences, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India.
authors.forename: Sirimavo
authors.initials: S
authors.lastname: Nair
authors.affiliation: Division of Endocrinology and Thyroid Research, Institute of Nuclear Medicine and Allied Sciences, Timarpur, New Delhi, India.
authors.forename: Satveer
authors.initials: S
authors.lastname: Singh
keywords: Anti-thyroid peroxidase; pregnant women; reference intervals; thyroid function tests; trimester