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 Table of Contents  
LETTER TO THE EDITOR
Year : 2019  |  Volume : 31  |  Issue : 4  |  Page : 983

Maternal thyroid status and its relation to ferritin and vitamin B12 in Saudi pregnant women


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Submission17-Jul-2019
Date of Acceptance14-Jan-2020
Date of Web Publication18-Aug-2020

Correspondence Address:
Mahmood D. Al-Mendalawi
P.O. Box 55302, Baghdad Post Office, Postal code 1111, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejim.ejim_104_19

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How to cite this article:
Al-Mendalawi MD. Maternal thyroid status and its relation to ferritin and vitamin B12 in Saudi pregnant women. Egypt J Intern Med 2019;31:983

How to cite this URL:
Al-Mendalawi MD. Maternal thyroid status and its relation to ferritin and vitamin B12 in Saudi pregnant women. Egypt J Intern Med [serial online] 2019 [cited 2020 Sep 27];31:983. Available from: http://www.esim.eg.net/text.asp?2019/31/4/983/292186



Dear editor,

I read with interest the distinguished study by Mogahed et al. [1] published in April–June 2019 issue of the Egyptian Journal of Internal Medicine. The authors studied thyroid status in Saudi pregnant women and its relation to serum ferritin and vitamin B12. They found that serum thyroid-stimulating hormone level was lower in pregnant than nonpregnant women. The most common thyroid disorder was subclinical hypothyroidism (35.5%) followed by overt hypothyroidism (10%) and hypothyroxinemia (2.2%) in pregnant women. Blood hemoglobin (HB) and serum vitamin B12 levels were significantly lower in first and second trimesters of pregnancy compared with controls (P=0.001). Serum free thyroxin was positively correlated with blood HB and serum ferritin, whereas serum thyroid-stimulating hormone was negatively correlated with blood HB and serum ferritin [1]. I assume that these results must be interpreted with caution owing to the presence of the following methodological limitation. It is obvious that precise interpretation of thyroid hormones during pregnancy in a given population necessitates using local trimester-specific reference intervals. Truly, trimester-specific reference ranges for thyroid hormones have been constructed for certain populations [2],[3]. In the study methodology, Mogahed et al. [1] mentioned that they referred to two standards in assessing thyroid status in their studied population, namely the guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the currently available report that included normal pregnant participants from the Gulf region. I assume that both standards cannot be applied to the Saudi pregnant population. The first standard was designed for white population [4], whereas the second standard was constructed for mixed ethnic pregnant population in the United Arab Emirates [5]. Kingdome of Saudi Arabia is not a multi-ethnic country. I assume that formulation of trimester-specific normative data of thyroid hormones for Saudi pregnant women is of utmost importance. Employment of that national standard in the clinical settings and researches could better define the prevalence of thyroid disorders and associated factors in Saudi pregnant women.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mogahed MM, Amer EE, El-Awady MA. Maternal thyroid status and its relation to ferritin and vitamin B12 in Saudi pregnant women. Egypt J Intern Med 2019; 31:129–135.  Back to cited text no. 1
  [Full text]  
2.
Kim HJ, Cho YY, Kim SW, Kim TH, Jang HW, Lee SY et al. Reference intervals of thyroid hormones during pregnancy in Korea, an iodine-replete area. Korean J Intern Med 2018; 33:552–560.  Back to cited text no. 2
    
3.
Han L, Zheng W, Zhai Y, Xie X, Zhang J, Zhang S et al. Reference intervals of trimester-specific thyroid stimulating hormone and free thyroxine in Chinese women established by experimental and statistical methods. J Clin Lab Anal 2018; 32:e22344.  Back to cited text no. 3
    
4.
Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R et al. Guidelines of the American thyroid association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21:1081–1125.  Back to cited text no. 4
    
5.
Dhatt GS, Jayasundaram R, Wareth LA, Nagelkerke N, Jayasundaram K, Darwish EA et al. Thyrotrophin and free thyroxine trimester-specific reference intervals in a mixed ethnic pregnant population in the United Arab Emirates. Clin Chim Acta 2006; 370:147–151.  Back to cited text no. 5
    




 

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