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Can serum ferritin predict thyroid performance in the first trimester?

OBJECTIVE
The primary aim of the study was to establish a reference value for the thyroid hormone in the first trimester of pregnancy in Iraq's population. The second aim was to look into the correlation between iron deficiency anaemia and thyroid hormone.


Methods
In a cross-sectional study conducted at the National Center of Haematology, 74 consented pregnant women at a gestational age < 13 weeks were recruited. An estimation was made for iron indices [haemoglobin, serum ferritin] and Thyroid Function Test [Triiodothyronine, Thyroxine and Thyroid-stimulating hormone] via collected blood samples.


RESULTS
The reference value for thyroid hormones was 1.79±2.05 pmol / l for Thyroid-stimulating hormone, 4.59±3.35 pmol / l for Thyroxine and 191±62.1 ng/dl for Triiodothyronine. Correlation showed an inverse relationship of Thyroid-stimulating hormone with serum haemoglobin and a positive correlation between Triiodothyronine and Thyroxine versus serum haemoglobin and ferritin. Mallow's coefficient of correlation evaluated the strength of the association between serum haemoglobin against Thyroid-stimulating hormone, Triiodothyronine, and Thyroxine. The strongest association was for Thyroxine.Thyroid-stimulating hormone, Thyroxine, and Triiodothyronine taken as independent variables were challenged against serum ferritin and haemoglobin as dependent variables. The only significant correlation was for serum ferritin and thyroid markers.


CONCLUSIONS
First-trimester screening for ferritin, in addition to routine haemoglobin testing, can reveal masked depleted iron stores. Hidden thyroid disease can be associated with anaemia, so Thyroid-stimulating hormone screening is recommended. Early diagnosis of these deficiencies in the first trimester will stop their impact on both the foetus and the mother's well being.