Association between maternal thyroid function in early pregnancy and gestational diabetes: a prospective cohort study
Kaikun Huang, Shaofei Su, Xueran Wang, Minhui Hu, Rong Zhao, Shen Gao, Enjie Zhang, Jianhui Liu, Shuanghua Xie, Yingyi Luan, Yongqing Sun, Yue Zhang, Wentao Yue, Ruixia Liu, Chenghong Yin- Biochemistry (medical)
- Clinical Biochemistry
- Endocrinology
- Biochemistry
- Endocrinology, Diabetes and Metabolism
Abstract
Context
Previous studies on the relationship between thyroid gland function and the development of gestational diabetes mellitus (GDM) have reported different results, leading to the need for a cohort study design with a large sample size.
Objective
We aimed to investigate the relationship between thyroid function in early pregnancy and GDM.
Design
This was a prospective cohort study based on the China Birth Cohort Study (CBCS), from February 2018 to December 2020.
Setting
The study took place at a tertiary maternal and child health hospital.
Participants
A total of 36,256 pregnant women were successfully recruited based on the CBCS.
Main Outcome Measures
The main outcome measure was GDM.
Results
This study consisted of 26,742 pregnant women who met the inclusion criteria, of which 3,985 (14.90%) were diagnosed with GDM, and the women with GDM were older than their healthy counterparts (33.26 ± 4.01 vs. 31.51 ± 3.76 years, P < .001). After removing potential influencing variables, we found that increased thyroid-stimulating hormone (TSH) (aOR = 1.030, 95% CI 1.007, 1.054, P = .012) and subclinical hypothyroidism (SCH; aOR = 1.211, 95% CI 1.010, 1.451, P = .039), but not free thyroxine (FT4) or thyroid peroxidase antibody (TPOAb), were associated with the occurrence of GDM. Further analysis indicated a nonlinear relationship between TSH and GDM (P < .05): when TSH ≤ 1.24 mIU/L, the occurrence of GDM was elevated with increasing TSH, but when TSH > 1.24 mIU/L, this trend was not obvious.
Conclusion
High TSH might be associated with increased risk of GDM.