Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism

Spyridoula Maraka, Naykky M. Singh Ospina, Derek T. O'Keeffe, Rene Rodriguez-Gutierrez, Ana E. Espinosa De Ycaza, Chung Il Wi, Young J. Juhn, Charles C. Coddington, Victor M. Montori, Marius N. Stan

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Background: Subclinical hypothyroidism (SCH) has been associated with increased risk of adverse pregnancy outcomes in some, but not all, studies. Uncertainty remains regarding the impact of levothyroxine (LT4) therapy on improving health outcomes in pregnant women with SCH. The objective of this study was to assess the potential benefits of LT4 therapy in pregnant women with SCH. Methods: The medical records were reviewed of pregnant women with SCH, defined as an elevated serum thyrotropin (TSH) of >2.5 mIU/L for the 1st trimester or >3 mIU/L for the 2nd and 3rd trimesters, but ≤10 mIU/L. Pregnant women were divided into two groups depending on whether they received LT4 (group A) or not (group B). Pregnancy loss and other pre-specified adverse outcomes were evaluated during follow-up. Results: There were 82 women in group A and 284 in group B. Group A had a higher body mass index (p = 0.04) and a higher serum TSH level (p < 0.0001) compared with group B. Group A had fewer pregnancies lost (n = 5 [6.1%] vs. n = 25 [8.8%]; p = 0.12), low birth weight (LBW) offspring (1.3% vs. 10%; p < 0.001), and no neonates with a five-minute Apgar score ≤7 (0% vs. 7%; p < 0.001) compared with group B. Other pregnancy-related adverse outcomes were similar between the two groups. Inferences remained unchanged after considering different models to adjust for potential predictors of outcome. Conclusions: LT4 therapy is associated with a decreased risk of LBW and a low Apgar score among women with SCH. This association awaits confirmation in randomized trials before the widespread use of LT4 therapy in pregnant women with SCH.

Original languageEnglish (US)
Pages (from-to)980-986
Number of pages7
Issue number7
StatePublished - Jul 2016

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


Dive into the research topics of 'Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism'. Together they form a unique fingerprint.

Cite this