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Article: The effect of pregnancy on thyroid nodule formation

TitleThe effect of pregnancy on thyroid nodule formation
Authors
Issue Date2002
PublisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org
Citation
Journal Of Clinical Endocrinology And Metabolism, 2002, v. 87 n. 3, p. 1010-1014 How to Cite?
AbstractEpidemiology data have revealed a higher prevalence of nodular goiters in women than men in both iodine-sufficient and iodine-deficient areas. Increased prevalence of thyroid nodules has also been reported in women with higher gravidity. However, the association between pregnancy and thyroid nodule formation has never been studied. The aim of our study was to evaluate the incidence of thyroid nodules during pregnancy and determine whether pregnancy will induce thyroid nodule formation. Two hundred twenty-one healthy southern Chinese women in the first trimester of their pregnancy were studied prospectively. Thyroid ultrasonography, thyroid function tests, and urinary iodine excretion were measured at first, second, and third trimesters of pregnancy as well as 6 wk and 3 months postpartum. Thyroid nodules (>2 mm in any dimension on ultrasonography) were detected in 34 (15.3%) subjects at first trimester, with 12 (5.4%) subjects having more than one nodule. Eight subjects had clinically palpable nodules. Women with thyroid nodules were older (P < 0.01) and had higher gravidity (P < 0.02) than those women without thyroid nodules. The volume of the single/dominant nodules increased from 60 (14-344) mm 3, median (interquartile range) at first trimester to 65 (26-472) mm 3 at third trimester (P < 0.02). These nodules remained enlarged at 103 (25-461) mm 3 6 wk postpartum (P < 0.005) and 73 (22-344) mm 3 at 3 months postpartum (P < 0.05). Patients with thyroid nodules had lower serum TSH values (P < 0.03) and higher Tg levels (P < 0.05) throughout pregnancy. Appearance of new nodules was detected in 25 (11.3%) women as pregnancy advanced so that by 3 months postpartum, the incidence of thyroid nodular disease was 24.4% (P < 0.02 vs. first trimester). Compared with those with no detectable nodules throughout pregnancy, subjects with new nodule formation had higher urinary iodine excretion from second trimester onward (P all < 0.05). However, no difference could be detected in their TSH and Tg levels throughout pregnancy. Fine-needle aspiration on nodules greater than 5 mm in any dimension after delivery (n = 21) confirmed the majority having histological features consistent with nodular hyperplasia. No thyroid malignancy was detected. In conclusion, pregnancy is associated with an increase in the size of preexisting thyroid nodules as well as new thyroid nodule formation. This may predispose to multinodular goiter in later life.
Persistent Identifierhttp://hdl.handle.net/10722/78703
ISSN
2015 Impact Factor: 5.531
2015 SCImago Journal Rankings: 2.940
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKung, AWCen_HK
dc.contributor.authorChau, MTen_HK
dc.contributor.authorLao, TTen_HK
dc.contributor.authorTam, SCFen_HK
dc.contributor.authorLow, LCKen_HK
dc.date.accessioned2010-09-06T07:45:48Z-
dc.date.available2010-09-06T07:45:48Z-
dc.date.issued2002en_HK
dc.identifier.citationJournal Of Clinical Endocrinology And Metabolism, 2002, v. 87 n. 3, p. 1010-1014en_HK
dc.identifier.issn0021-972Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/78703-
dc.description.abstractEpidemiology data have revealed a higher prevalence of nodular goiters in women than men in both iodine-sufficient and iodine-deficient areas. Increased prevalence of thyroid nodules has also been reported in women with higher gravidity. However, the association between pregnancy and thyroid nodule formation has never been studied. The aim of our study was to evaluate the incidence of thyroid nodules during pregnancy and determine whether pregnancy will induce thyroid nodule formation. Two hundred twenty-one healthy southern Chinese women in the first trimester of their pregnancy were studied prospectively. Thyroid ultrasonography, thyroid function tests, and urinary iodine excretion were measured at first, second, and third trimesters of pregnancy as well as 6 wk and 3 months postpartum. Thyroid nodules (>2 mm in any dimension on ultrasonography) were detected in 34 (15.3%) subjects at first trimester, with 12 (5.4%) subjects having more than one nodule. Eight subjects had clinically palpable nodules. Women with thyroid nodules were older (P < 0.01) and had higher gravidity (P < 0.02) than those women without thyroid nodules. The volume of the single/dominant nodules increased from 60 (14-344) mm 3, median (interquartile range) at first trimester to 65 (26-472) mm 3 at third trimester (P < 0.02). These nodules remained enlarged at 103 (25-461) mm 3 6 wk postpartum (P < 0.005) and 73 (22-344) mm 3 at 3 months postpartum (P < 0.05). Patients with thyroid nodules had lower serum TSH values (P < 0.03) and higher Tg levels (P < 0.05) throughout pregnancy. Appearance of new nodules was detected in 25 (11.3%) women as pregnancy advanced so that by 3 months postpartum, the incidence of thyroid nodular disease was 24.4% (P < 0.02 vs. first trimester). Compared with those with no detectable nodules throughout pregnancy, subjects with new nodule formation had higher urinary iodine excretion from second trimester onward (P all < 0.05). However, no difference could be detected in their TSH and Tg levels throughout pregnancy. Fine-needle aspiration on nodules greater than 5 mm in any dimension after delivery (n = 21) confirmed the majority having histological features consistent with nodular hyperplasia. No thyroid malignancy was detected. In conclusion, pregnancy is associated with an increase in the size of preexisting thyroid nodules as well as new thyroid nodule formation. This may predispose to multinodular goiter in later life.en_HK
dc.languageengen_HK
dc.publisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.orgen_HK
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolismen_HK
dc.rightsJournal of Clinical Endocrinology and Metabolism. Copyright © The Endocrine Society.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshPregnancy - physiologyen_HK
dc.subject.meshPregnancy Complications - epidemiology - ultrasonographyen_HK
dc.subject.meshPregnancy Trimester, Firsten_HK
dc.subject.meshPregnancy Trimester, Seconden_HK
dc.subject.meshPregnancy Trimester, Thirden_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshThyroid Nodule - epidemiology - etiology - ultrasonographyen_HK
dc.titleThe effect of pregnancy on thyroid nodule formationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0021-972X&volume=87&issue=3&spage=1010&epage=1014&date=2002&atitle=The+effect+of+pregnancy+on+thyroid+nodule+formationen_HK
dc.identifier.emailKung, AWC: awckung@hku.hken_HK
dc.identifier.emailLow, LCK: lcklow@hkucc.hku.hken_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.identifier.authorityLow, LCK=rp00337en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1210/jc.87.3.1010en_HK
dc.identifier.pmid11889153-
dc.identifier.scopuseid_2-s2.0-0036964996en_HK
dc.identifier.hkuros74916en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036964996&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume87en_HK
dc.identifier.issue3en_HK
dc.identifier.spage1010en_HK
dc.identifier.epage1014en_HK
dc.identifier.isiWOS:000174620600010-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.scopusauthoridChau, MT=7006073758en_HK
dc.identifier.scopusauthoridLao, TT=7005722132en_HK
dc.identifier.scopusauthoridTam, SCF=7202037323en_HK
dc.identifier.scopusauthoridLow, LCK=7007049461en_HK

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