ECEESPE2025 Poster Presentations Fetal and Neonatal Endocrinology (15 abstracts)
Lower FT4 levels are associated with increased risk of C-section or assisted delivery
David Strich 1 , 2 , Elia Strich 3 , Shalom Edri 1 , Cherut Meirman 4 , Gilad Karavani 1 , 5 & David Gillis 1 & 5
1Hebrew university of Jerusalem, Sharee Zedek Medical Center, Pediatric Endocrinology, Jerusalem, Israel; 2Clalit Health Service, Pediatric Specialists Clinics, Jerusalem, Israel; 3Ben Gurion University, Beer Sheva, Israel; 4Tel Aviv Unvirsity, Tel Aviv, Israel; 5Hadassah University Hospital, Ein-Kerem, Jerusalem, Israel.
JOINT2941
Background and Objective: Thyroid function tests (TFT) during pregnancy differ from extra-gestational levels, particularly during the first trimester. It is unknown if there is an association between thyroid hormone levels during the three trimesters of pregnancy and mode of delivery. We compared thyroid hormone levels with the relative prevalence of Caesarian section or assisted vaginal delivery (CSA) vs normal vaginal delivery (NVD).
Methods: Delivery and newborn data from the database of Hadassah Medical Center, Jerusalem, were combined with thyroid function tests taken from the same women during pregnancy in the Clalit HMO, Jerusalem district. TSH, FT3 and FT4 z-scores were calculated according to biweekly reference levels from the same population. The risk of having FT3 or FT4 lower than 1. 5 z-score and the median TSH was calculated for the CSA vs NVD groups.
Results: There were 17, 512 mother–child pairs, 13030 were NVD and 4512 were CSA. There was a higher prevalence of FT4 z-scores below -1. 5 in the CSA groups throughout all trimesters: first trimester: 7% vs. 3. 3% (P = 0. 001), second: 7. 3% vs. 2. 9% (P = 0. 001), third: 5. 9% vs. 2. 3 (P = 0. 039). For median TSH z-scores there was also a significant difference by mode of delivery, for CSA vs. NVD the median TSH were, by trimesters, respectively as follows: first: 1. 54miu/l vs. 1. 59 (P = 0. 07), second: -1. 74 vs. 1. 76 (P = 0. 001) and third: 1. 98 Vs. 2. 11 (P = 0. 04)
Conclusion: There is an association between gestational thyroid hormone levels and mode of delivery. We speculate that lower FT4 levels during pregnancy may be associated with lower smooth-muscle tone causing poorer uterine contractions. Further research is needed to better understand the clinical significance of this.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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