Objective To analyze the relationship between pre-pregnancy thyroid stimulating hormone (TSH) level and spontaneous abortion among first-time pregnant women and to provide clues for epidemiological research.
Methods From January 2013 to December 2018, we recruited 18 797 first-time pregnant women having pre-pregnancy eugenic health examination in Shenzhen city and with known pregnancy outcome and divided them into a case group (671 with spontaneous abortion) and a control group (18 126 with normal live birth). Chi-square test was used to compare baseline characteristics between the two groups and multivariate logistic regression model was adopted to analyze the impact of pre-pregnancy TSH level on spontaneous abortion risk in the women.
Results There was a significant difference between the cases and the controls in the distribution of pre-pregnancy TSH, with the decreased, normal high, and elevated rates of 2.27%, 14.42%, and 4.14% for the controls and 1.19%, 14.16%,and 6.56% for the cases, respectively. Compared to that for the women with normal pre-pregnancy TSH, the spontaneous abortion risk was 50% higher (odds ratio = 1.50, 95% confidence interval: 1.05 – 2.08) for the women with elevated pre-pregnancy TSH. No significant difference between the cases and the controls in the risk of spontaneous abortion among the women with normal high and decreased pre-pregnancy TSH levels.
Conclusion Elevated pre-pregnancy TSH level may increase spontaneous abortion risk among first-time pregnant women, suggesting that monitoring on thyroid function should be promoted among the first-time pregnant women with elevated pre-pregnancy TSH level.
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