Levothyroxine replacement dose in patients with hypothyroidism during pregnancy

doi:10.3969/j.issn.1004-583X.2016.06.020

Abstract

Abstract:

ObjectiveTo explore the levothyroxine dose in patients with hypothyroidism during pregnancy. MethodsA total of 274 pregnant subjects with hypothyroidism including 207 patients with subclinical hypothyroidism (SHT) and 67 patients with clinical hypothyroidism (HT) were enrolled in this study from March 2014 to March 2015. According to thyrotrophic (TSH) levels， the levothyroxine dose was adjusted to reach the targets with the first trimester TSH ranging 0.12.5 mU/L， the second trimester(T2) TSH ranging 0.23.0 mU/L and the third trimester(T3) TSH ranging 0.33.0 mU/L. The subjects were divided into different groups on the basis of TSH levels， including TSH1 group: TSH 35 mU/L， TSH2 group: TSH 58 mU/L， TSH3 group: TSH 810 mU/L， TSH4 group: TSH 1015 mU/L， TSH5 group: TSH 1520 mU/L and TSH6 group: TSH>20 mU/L. ResultsThe levothyroxine doses were respectively (52.26±19.43) μg in T1 period，( 56.69±20.58) μg in T2 period and (56.76±19.99) μg in T3 period in subclinical hypothyroidism， and respectively (64.58±50.26) μg in T1 period，(66.67±47.64) μg in T2 period and （65.91±34.06） μg in T3 period in clinical hypothyroidism. The doses of levothyroxine were （45.65±16.08） μg，（72.32±14.85） μg，（75.00±13.06) μg， (112.5±53.03) μg，(137.5±23.18) μg and (150.00±23.13) μg from TSH1 group to TSH6 group， respectively. The doses of levothyroxine in TSH2， TSH3， TSH4 and TSH5 groups were significantly higher than that of TSH1 group during T1 to T3 trimester (P<0.05). The doses of levothyroxine in TSH4， TSH5 and TSH6 groups were significantly higher than that of TSH2 group (P<0.05). The doses of levothyroxine in TSH4， TSH5 and TSH6 groups higher than TSH3 group (P<0.05); The doses of levothyroxine in TSH5 and TSH6 groups were significantly higher than that of TSH4 group (P<0.05). The dose of levothyroxine in TSH6 group were significantly higher than that of TSH5 group (P<0.05). ConclusionThe levothyroxine (LT4) dose in clinical hypothyroidism in T1， T2 and T3 trimester were significantly higher than those in subclinical hypothyroidism (P<0.05). The dose of levothyroxine sodium increased significantly accompanied by the increased TSH level during pregnancy (P<0.05).

Key words: hypothyroidism, pregnancy, thyroxine

Chen Lin1，2， Liu Jun2， Zhuang Chanjuan1， Li Guimei1， Deng Dongmei1. Levothyroxine replacement dose in patients with hypothyroidism during pregnancy[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2016.06.020.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2016.06.020

https://huicui.hebmu.edu.cn/EN/Y2016/V31/I6/669

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Levothyroxine replacement dose in patients with hypothyroidism during pregnancy

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