{"doi":"10.1530/eje-08-0709","title":"Gestational thyroid function abnormalities in conditions of mild iodine deficiency: early screening versus continuous monitoring of maternal thyroid status","abstract":"<jats:sec><jats:title>Objective</jats:title><jats:p>To longitudinally evaluate the timing of maternal thyroid underfunction occurrence in mildly iodine-deficient (ID) pregnant women, and ultimately assess the benefit of thyroid function testing at early gestation only in identifying maternal thyroid underfunction.</jats:p></jats:sec><jats:sec><jats:title>Participants/methods</jats:title><jats:p>Serum free-thyroxine and TSH were measured in 220 consecutive women once in early pregnancy (by week 12) and twice per trimester subsequently. Anti-thyroperoxidase and anti-thyroglobulin were also determined at initial and final observation.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Thyroid autoantibodies were detectable in 8.2% women. Overall, the prevalence of hypothyroidism over the course of gestation was 11.8% (26/220), with a relative risk of hypothyroidism in antibody-positive women of 5.0 (<jats:italic>χ</jats:italic><jats:sup>2</jats:sup> 20.02, <jats:italic>P</jats:italic>&lt;0.0005). Nonetheless, almost 70% hypothyroid women tested negative for thyroid autoantibodies. Fifteen/26 (57.7%) hypothyroid women were identified at presentation, and the remaining 11 at either early (6/11) or late (5/11) phases of the 2nd trimester. Isolated hypothyroxinemia was observed in 56/220 (25.4%) women, mostly from the 2nd trimester onwards.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In mildly ID areas thyroid function testing early in gestation seems to be only partly effective in identifying thyroid underfunction in pregnant women. Indeed, in our series more than 40% hypothyroid women would not have been diagnosed had we limited our observation to early thyroid function tests alone. Although thyroid autoimmunity carried a 5-fold increased risk of hypothyroidism, iodine deficiency seems to be a major determinant in the occurrence of thyroid underfunction. Adequate iodine supplementation should be strongly recommended to meet the increased hormone demand over gestation.</jats:p></jats:sec>","journal":"European Journal of Endocrinology","year":2009,"id":30457,"datarank":3.4784050719384907,"base_score":4.2626798770413155,"endowment":4.2626798770413155,"self_citation_contribution":0.6394019815561974,"citation_network_contribution":2.839003090382293,"self_endowment_contribution":0.6394019815561974,"citer_contribution":2.839003090382293,"corpus_percentile":null,"corpus_rank":null,"citation_count":70,"citer_count":63,"citers_with_citation_signal":53,"citers_with_endowment":53,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":165383,"name":"Vincenzo Pio Lo Presti","orcid":null,"position":1,"is_corresponding":false},{"id":165384,"name":"Filiberto Mattina","orcid":null,"position":2,"is_corresponding":false},{"id":165385,"name":"Alfredo Mancuso","orcid":null,"position":3,"is_corresponding":false},{"id":165386,"name":"Antonio De Vivo","orcid":null,"position":4,"is_corresponding":false},{"id":165387,"name":"Grazia Giorgianni","orcid":null,"position":5,"is_corresponding":false},{"id":165388,"name":"Beatrice Di Bella","orcid":null,"position":6,"is_corresponding":false},{"id":165389,"name":"Francesco Trimarchi","orcid":null,"position":7,"is_corresponding":false},{"id":165390,"name":"Francesco Vermiglio","orcid":null,"position":8,"is_corresponding":false},{"id":165382,"name":"Mariacarla Moleti","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"base_score":4.2626798770413155,"endowment":4.2626798770413155,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"19179457","pmcid":null,"openalex_id":"https://openalex.org/W2123096865","authors":[],"funders":[],"total_grants":0,"fwci":5.9774,"citation_percentile":0.97045908,"influential_citations":1,"citation_trend":[{"year":2012,"count":11},{"year":2013,"count":4},{"year":2014,"count":6},{"year":2015,"count":1},{"year":2016,"count":5},{"year":2017,"count":5},{"year":2018,"count":3},{"year":2019,"count":2},{"year":2020,"count":2},{"year":2021,"count":2},{"year":2022,"count":3},{"year":2023,"count":1},{"year":2024,"count":1},{"year":2025,"count":2}],"oa_status":"closed","license":"other-open","oa_locations":[{"url":"https://academic.oup.com/ejendo/article-pdf/160/4/611/45870204/611.pdf","host_type":"BRONZE"},{"url":"https://eje.bioscientifica.com/view/journals/eje/160/4/611.xml","host_type":"publisher"},{"url":"https://doi.org/10.1530/eje-08-0709","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/19179457","host_type":"repository"}],"fields_of_study":["Thyroid Disorders and Treatments","Thyroid Cancer Diagnosis and Treatment","Head and Neck Anomalies","Medicine","Environmental Science","Adult","Female","Humans","Hypothyroidism","Infant, Newborn","Iodide Peroxidase","Iodine","Italy","Longitudinal Studies","Monitoring, Physiologic","Pregnancy","Pregnancy Complications","Pregnancy Outcome","Risk","Thyroid Diseases","Thyroid Function Tests","Thyrotropin","Thyroxine","Young Adult"],"mesh_terms":["Adult","Female","Humans","Hypothyroidism","Infant, Newborn","Iodide Peroxidase","Iodine","Italy","Longitudinal Studies","Monitoring, Physiologic","Pregnancy","Pregnancy Complications","Pregnancy Outcome","Risk","Thyroid Diseases","Thyroid Function Tests","Thyrotropin","Thyroxine","Young Adult"],"keywords":["Medicine","Thyroid function","Endocrinology","Internal medicine","Iodine deficiency","Thyroid","Iodine","Thyroid function tests","Pregnancy","Gestation","Gestational age","Biology","Chemistry"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-06-09T02:34:20.475985Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}