• Minhui Hu, Shen Gao, Kaikun Huang, Xueran Wang, Juan Li, Shuangying Li, Zhan Li, Wentao Yue, Shaofei Su, Enjie Zhang, Shuanghua Xie, Jianhui Liu, Yue Zhang, Yingyi Luan, Ruixia Liu, and Chenghong Yin.
• Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
• Int J Med Sci. 2025 Jan 1; 22 (3): 575584575-584.

AbstractBackground: The relationship between maternal thyroid-stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) status and hypertensive disorders of pregnancy (HDP) remains uncertain. Methods: This was a prospective cohort study based on the China Birth Cohort Study (CBCS). 36,256 women were included at 6 to 13+6 gestation from February 2018 to December 2020. Generalized linear mixed models were used to investigate the association between thyroid function and HDP/BP. We further performed multiple subgroup analyses to test the robustness of this association. Results: The final study population was 25,608, and the overall incidence of HDP was 8.0%. After adjusting for maternal age, pre-pregnancy BMI, education, household annual income, smoking status, conception method and parity, the odds of HDP increased by 3.0% with a 1-unit increase in TSH (OR 1.03, 95% CI 1.04-1.06). Maternal TSH and TPOAb positivity were associated with a higher risk of preeclampsia or eclampsia but not gestational hypertension (TSH: OR 1.04, 95% CI 1.01-1.07; TPOAb positivity: OR 1.30, 95% CI 1.09-1.56). TSH and TPOAb positivity were significantly and positively associated with systolic pressure (TSH: β 0.02, 95% CI 0.07-0.26; TPOAb positivity: β 0.02, 95% CI 0.12-0.98) and diastolic pressure (TSH: β 0.02, 95% CI 0.02-0.17; TPOAb positivity: β 0.02, 95% CI 0.06-0.75). Subgroup analyses suggested that the association between TSH and diastolic pressure was stronger in those with BMI ≥ 25 kg/m2 (P = 0.014). Conclusions: Our founds suggest that high TSH and TPOAb positivity in the first trimester are associated with an increased risk of preeclampsia or eclampsia.© The author(s).

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