Review Article

Challenges in Interpretation of Thyroid Function Tests in Pregnant Women with Autoimmune Thyroid Disease

Table 1

Trimester-specific reference ranges in various studies. Only a sample of studies is shown in order to exemplify the variety of values obtained in different populations of pregnant women and by different methods. Free thyroid hormone values are given—in some of the studies also total hormones have been measured together with T3 uptake to perform a free T4 index/estimate. Not all studies excluded pregnant women with thyroid autoantibodies.

TSHFree T4Free T3
Method1st trim2nd trim3rd trim1st trim2nd trim3rd trim1st trim2nd trim3rd trim

Boas et al. [13]All trim
Longitudinal
Roche Modular Elecsys0.2–3.40.4–3.60.4–4.212–2210–1810–183.5–6.33.3–5.73.3–5.8
Cotzias et al. [28]All trim
Cross-sectional
ADVIA Centaur System0–5.50.5–3.50.5–4.010–169–15.58–14.53–73–5.52.5–5.5
Dhatt et al. [32]All trim/Arabs
Cross-sectional
Abbott Architect0.06–8.30.17–5.90.2–6.98.9–24.68.4–19.38.0–18.0NDNDND
Dhatt et al. [32]All trim/Asians
Cross-sectional
Abbott Architect0.12–7.40.3–5.50.3–4.911.3–21.99.7–18.58.9–16.6NDNDND
Gilbert et al. [31]1st trimAbbott Architect0.02–2.2NDND10–17.8NDND3.3–5.7NDND
Gong and Hoffman [34]All trim
Cross-sectional
Roche Modular ElecsysNDNDND11–199.7–17.58.1–15.3NDNDND
Lambert-Messerlian et al.* [24]1st and 2nd trim
Longitudinal
Immulite 20000.1–2.70.4–2.8ND0.9–1.40.8–1.3NDNDNDND
Larsson et al. [37]All trim
Longitudinal
Abbott Architect0.1–3.40.4–3.40.4–4.0NDNDNDNDNDND
La’ulu et al. [30]2nd trim
Cross-sectional
Abbott Architect i2000SRND0.1–3.3NDND9.1–15.4NDND3.8–6.0ND
Marwaha et al. [29]All trim
Cross-sectional
Roche Modular Elecsys0.6–5.00.4–5.80.7–5.712–19.59.5–19.611.3–17.71.9–5.93.2–5.73.3–5.2
Pearce et al. [36]1st trim
Cross-sectional
0.04–3.6NDNDNDNDNDNDND
Price et al. [33]1st and 2nd trim/Asians
Cross-sectional
Bayer Diagnostics ACS:1800.6–1.31.0–1.8ND11.8–13.410.9–12.1NDNDNDND
Price et al. [33]1st and 2nd trim/Caucasian
Cross-sectional
Bayer Diagnostics ACS:1800.7–1.11.2–1.5ND12.0–12.811.2–11.8NDNDNDND
Soldin et al. [35]All trim
Longitudinal
Tandem Mass Spectrometry0.2–2.990.5–3.00.4–2.83.7–23.47.4–18.98.3–15.6NDNDND

TSH was measured in mU/L, free T4 in pmol/L, and free T3 in pmol/L. ND: not done. * the 5th and 95th percentile; free T4 in μg/L.