ECEESPE2025 Rapid Communications Rapid Communications 11: Thyroid Part 1 (6 abstracts)
Different thyroid hormone profiles in women with euploid compared to aneuploid pregnancy loss – a prospective cohort study
Sofie Bliddal 1,2 , David Westergaard 1 , Tanja Hartwig 1 , Laura Vexøe 1 , Emilie Madsen 1 , Ida Behrendt-Møller 1 , Erik Sørensen 3 , Giuliana Beneduce 1 , Louise Ambye 4 , Ulla Feldt-Rasmussen 2 , Karina Banasik 1 , Dorte Glintborg 5 , Steen J. Bonnema 5 , Pia Kamstrup 6 & Henriette Svarre Nielsen 1
1Copenhagen University Hospital Hvidovre, Department of Gynecology and Obstetrics, Hvidovre, Denmark; 2Copenhagen University Hospital Rigshospitalet, Department of Kidney and Endocrine Disease, Copenhagen, Denmark; 3Copenhagen University Hospital Rigshospitalet, Department of Clinical Immunology, Copenhagen, Denmark; 4Copenhagen University Hospital Hvidovre, Hvidovre Hospitals’ NIPT Center, Hvidovre, Denmark; 5Odense University Hospital, Department of Endocrinology M, Odense, Denmark; 6Copenhagen University Hospital Herlev, Copenhagen, Denmark
JOINT3378
Background: Thyroid dysfunction is associated with adverse reproductive outcomes including pregnancy loss. Approximately 55% of pregnancy losses are due to lethal chromosome abnormalities (aneuploid losses), whereas fetuses with a normal number of chromosomes (euploid) are potentially viable. Euploid pregnancy loss is suspected to be due to maternal comorbidity, e.g. thyroid dysfunction, although this has not previously been studied. We investigated if thyroid function and autoimmunity were associated with the risk of euploid pregnancy loss.
Methods: Prospective cohort study of women experiencing pregnancy loss at three Danish University hospitals (2020–2024). Blood was drawn at the time of pregnancy loss and at follow-up four to eight weeks after. Analyzes included thyroid stimulating hormones (TSH), free and total thyroxine (FT4, TT4), total triiodothyronine (TT3), human chorionic gonadotropin (hCG), thyroid peroxidase and thyroglobulin antibodies (TPOAb, TgAb). Antibody positivity: >60 kIU/l. Fetal chromosome status was determined by cell-free fetal DNA or fetal tissue sequencing to detect aneuploidy. Logistic regression models were adjusted for age, gestational week, body mass index, and thyroid medication use.
Results: A total of 1,031 out of 2,018 (51%) pregnancy losses were euploid. The euploid pregnancy loss risk did not differ according to TSH (adjusted odds ratio (aOR) 0.9, 95% confidence interval (CI) 0.8;1.1), FT4 (aOR 1.0, 95%CI 1.0;1.0), TPOAb positivity (aOR 0.99, 95%CI 0.68;1.43), or TgAb positivity (aOR 0.96, 95%CI 0.66;1.41). In contrast, the euploid loss rate was higher in women with TT3>2.6 nmol/l (laboratory cut-off) vs TT3≤2.6 nmol/l (n=61/85, 71.8% vs. n=470/1,521 48.6%, P<0.001) and TT4 >140 nmol/l (laboratory cut-off) vs ≤140 nmol/l (n=248/425 58.4% vs. n=552/1,180 46.8%, P<0.001). Also, in the adjusted regression models the euploid pregnancy loss risk was positively associated with TT3 concentration (aOR) 2.0, 95%CI 1.5;2.6) and TT4 concentration (aOR 1.09, 95%CI 1.05;1.13). This remained significant when further adjusting for TSH, TPOAb, TgAb, and hCG concentrations (TT3 aOR 2.7, 95%CI 1.44;5.33, and TT4 aOR 1.16, 95%CI 1.06;1.27). Noteworthy, 15 of 18 (83%) women with high TT3 and TPOAb- or TgAb-positivity had a euploid pregnancy loss. The majority of women with high TT3 or TT4 at inclusion had normalized hormone concentrations at follow-up (n=49/52, 94.2% for TT3 and n=256/291, 88.0% for TT4).
Conclusion: Women experiencing a euploid pregnancy loss have higher TT3 and TT4 concentrations at the time of the loss, but not outside of pregnancy. The mechanisms, including a potential interplay with thyroid antibody-positivity, needs further exploration.
Volume 110
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Endocrine Abstracts
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