Paper linking covid and thyroid function changes in early pregnancy

[diogenes]

This paper (only as yet out as an abstract and title, shows how covid affects thyroid function in early pregnancy. Might be useful to those unfortunate enough to have covid whilst getting pregnant:

Front. Endocrinol. | doi: 10.3389/fendo.2020.606723

Thyroid Hormone Changes in Early Pregnancy Along With the COVID-19 Pandemic

Tingting Lin1, Chen Zhang1, Hanqiu Zhang1, Yu Wang1, Lei Chen1, Cindy-Lee Dennis1, Hefeng Huang1* and Yanting Wu1*

1International Peace Maternity and Child Health Hospital, China

Purpose: COVID-19 (Coronavirus Disease 2019) was first reported in December 2019 and quickly swept across China and around the world. Levels of anxiety and depression were increased among pregnant women during this infectious pandemic. Thyroid function is altered during stressful experiences and any abnormality during early pregnancy may significantly affect fetal development and pregnancy outcomes. This study is to find whether the COVID-19 pandemic would induce thyroid hormone changes in early pregnant women.

Methods: This study comprised of two groups of pregnant women in Shanghai in their first trimester – those pregnant women before the COVID-19 outbreak from January 20, 2019, to March 31, 2019 (Group 1) and those pregnant during the COVID-19 outbreak from January 20, 2020, to March 31, 2020 (Group 2). All women were included if they had early pregnancy thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), and total thyroxine (TT4) concentrations, thyroid peroxidase (TPO) antibody or thyroglobulin antibody (TgAb) available and did not have a history of thyroid diseases or received thyroid treatment before or during pregnancy. We used propensity score matching to form a cohort in which patients have similar baseline characteristics.

Results: Among 3338 eligible pregnant women, 727 women in Group 1 and 727 in Group 2 had similar propensity scores and were included in the analyses. Pregnant women in Group 2 had significantly higher FT3(5.7 vs. 5.2pmol/L, P<0.001) and lower FT4(12.8 vs. 13.2pmol/L, P<0.001) concentrations compared with those in Group 1. Pregnant women in Group 2 were more likely to develop isolated hypothyroxinemia (11.6% vs. 6.9%, OR, 1.75 [95%CI, 1.20-2.53], P=0.003) than Group 1 but had significantly lower risk of TgAb positivity (12.0% vs. 19.0%, OR, 0.58 [95%CI, 0.43-0.78], P<0.001).

Conclusion: Pregnant women in their first trimester in Shanghai during the COVID-19 outbreak were at an increased risk to have higher FT3 concentrations, lower FT4 concentrations, and isolated hypothyroxinemia. The association between thyroid hormones, pregnancy outcomes, and the COVID-19 outbreak should be explored further.

[tattybogle]

That's interesting , i take it the women did not actually have covid (as far as they know) and they were just looking for effects of a stressful situation on thyroid function ?

[diogenes Remembering in reply to tattybogle]

Yes, I believe that the stress of fearing to catch covid made for a psychotic worry (fear of catching the virus and losing the baby). This pschycological stress influence is well described in our latest paper I publicised on the site recently. Psychological effects on the FT4/3/TSH balance have been sorely underestimated up to now. They can mimic subclinical hypothyroidism and have been confused with it.

[tattybogle in reply to diogenes]

I guess it's good to find the facts on this issue , even if we don't like the answers, and you can't get a better control for this study than a global pandemic. I think i'd be very stressed about a multitude of scenarios if i was pregnant in the current climate.

I think i would be odd if psychological stress did not effect thyroid function, conversion etc. since i assume the whole point of the endocrine system's complexities is to try and maintain balance during all kind of stressors.

[TSH110 in reply to diogenes]

I wonder by what mechanism, it’s very interesting. I suppose the mind/body separation is just a construct. The two are inextricably linked