A Bayesian model to estimate the cutoff value of TSH for management of preterm birth
- Publisher:
- Public Library of Science (PLoS)
- Publication Type:
- Journal Article
- Citation:
- PLOS ONE, 2023, 18, (3), pp. e0283503
- Issue Date:
- 2023
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BACKGROUND Determining a thyroid hormone cutoff value in pregnancy is challenging issue and several approaches have been introduced to optimize a utility function We aimed to estimate the cutoff value of TSH using Bayesian method for prediction of preterm birth METHODS This study was a secondary analysis of the population based data collected prospectively within the framework of the Tehran Thyroid and Pregnancy Study A total of 1 538 pregnant women attending prenatal clinics RESULTS Using Bayesian method resulted a TSH cutoff of 3 97mIU L 95 CI 3 95 4 00 for distinguishing pregnant women at risk of preterm birth The cutoff was associated with acceptable positive predictive and negative predictive values 0 84 95 CI 0 80 0 88 and 0 92 95 CI 0 91 0 94 respectively In women who were negative for thyroid peroxides antibody TPOAb with sufficient urinary iodine concentration UIC the TSH cutoff of 3 92 mIU L 95 CI 3 70 4 had the highest predictive value whereas in TPOAb positive women with insufficient UIC the cutoff of 4 0 mIU L 95 CI 3 94 4 could better predict preterm birth Cutoffs estimated in this study are close to the revised TSH value of 4 0mIU L which is currently recommended by the American Thyroid Association CONCLUSION Regardless of TPOAb status or iodine insufficiency risk of preterm labor is increased in pregnant women with TSH value of 3 92 mIU L these women may benefit from Levothyroxine LT4 therapy for preventing preterm birth
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