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Study Finds Link Between Preeclampsia and Reduced Thyroid Function BETHESDA, Md -- November 18, 2009 -- Women who experience preeclampsia may have an increased risk for reduced thyroid functioning later in life, according to a study published in the November issue of BMJ. The analysis combined 2 separate studies which each suggested a link between preeclampsia and reduced thyroid function. In the first study, women who developed preeclampsia were more likely to have slightly reduced thyroid functioning during the last weeks of their pregnancies. The second study found that women who had preeclampsia during their pregnancies were more likely to have reduced thyroid functioning more than 20 years after they had given birth, when compared with women who had not had preeclampsia during pregnancy. The study authors advised physicians treating women with a history of preeclampsia to be aware that this group of patients may be at increased risk for reduced thyroid functioning. Richard J. Levine, MD, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, Maryland, and colleagues previously reported that high levels of 2 molecules in the blood may cause symptoms of preeclampsia. One of those molecules, soluble fms-like tyrosine kinase 1 (sFlt-1), acts by blocking a protein called vascular endothelial growth factor (VEGF). Previous studies have found that some cancer patients receiving treatments that block VEGF have developed hypothyroidism. For this reason, Dr. Levine investigated whether women with preeclampsia might also experience similar problems with thyroid functioning. For the current study, researchers tested blood samples collected from another study on preeclampsia, for levels of thyroid stimulating hormone (TSH). The researchers found a link between preeclampsia and reduced thyroid functioning. Early in their pregnancies, women who went on to develop preeclampsia had thyroid functioning identical to that of the women who never developed preeclampsia. But toward the end of their pregnancies, the women with preeclampsia had, on average, much higher levels of TSH than women with no history of preeclampsia. Moreover, the increase in TSH was strongly associated with an increase in blood levels of sFLT-1. Only 2 of the women had both high levels of TSH and low levels of thyroid hormone. In both women, hypothyroidism developed during pregnancy, but after the onset of preeclampsia. Although they did not have any other symptoms of reduced thyroid function, 1 out of every 4 of the other women with preeclampsia had levels of TSH above the range considered normal. Of the women without preeclampsia, that proportion was only 1 in 7. The first study did not provide information on whether reduced thyroid functioning extended beyond the end of the pregnancy, when preeclampsia’s symptoms cease. The researchers next turned to data collected in the mid-1990s in a county wide study in Norway. The researchers analysed data from 7,121 women who had given birth to a first child in 1967 or later, and had had their blood samples tested for thyroid function in the county wide study in the mid-1990s. The researchers discovered that the women who had preeclampsia in their first pregnancy were 1.7 times as likely to have high TSH as the women who had not had preeclampsia. Women who had preeclampsia in both their first and second pregnancies were nearly 6 times as likely to have high TSH levels. The TSH testing took place in the 1990s, an average of more than 20 years after the women’s first pregnancies. “Many of these women still had reduced thyroid function,” said Dr. Levine. “This suggests that a history of preeclampsia may predispose women to the later development of reduced thyroid function.” SOURCE: National Institutes of Health E-mail this page to a friend or colleague! To print, use this version