Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center

Introduction: gestational diabetes mellitus (GDM) commonly appears between the second and third trimesters of pregnancy as a result of hormonal changes that induce a transitory state of insulin resistance (IR) in the mother, allowing a greater supply of glucose to the fetus. After GDM, thyroid disea...

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Autores:
Sierra-Castrillo, Jhoalmis
Perdomo Dominguez, Yojanna
Villamizar Carvajal, Jeferson Adrián
Muñoz-Bravo, Adriana
Gómez-Rave, Lyz Jenny
Bermúdez, Valmore
Tipo de recurso:
Fecha de publicación:
2022
Institución:
Universidad Simón Bolívar
Repositorio:
Repositorio Digital USB
Idioma:
eng
OAI Identifier:
oai:bonga.unisimon.edu.co:20.500.12442/13155
Acceso en línea:
https://hdl.handle.net/20.500.12442/13155
https://doi.org/10.5281/zenodo.7415235
Palabra clave:
Diabetes gestational
Thyroid disease
Pregnancy
Prevalence
Diabetes gestacional
Enfermedades de la tiroides
Embarazo
Prevalencia
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openAccess
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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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dc.title.eng.fl_str_mv Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
dc.title.translated.spa.fl_str_mv Diabetes gestacional y alteraciones tiroideas en gestantes de un centro especializado de diagnóstico materno-infantil
title Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
spellingShingle Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
Diabetes gestational
Thyroid disease
Pregnancy
Prevalence
Diabetes gestacional
Enfermedades de la tiroides
Embarazo
Prevalencia
title_short Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
title_full Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
title_fullStr Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
title_full_unstemmed Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
title_sort Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center
dc.creator.fl_str_mv Sierra-Castrillo, Jhoalmis
Perdomo Dominguez, Yojanna
Villamizar Carvajal, Jeferson Adrián
Muñoz-Bravo, Adriana
Gómez-Rave, Lyz Jenny
Bermúdez, Valmore
dc.contributor.author.none.fl_str_mv Sierra-Castrillo, Jhoalmis
Perdomo Dominguez, Yojanna
Villamizar Carvajal, Jeferson Adrián
Muñoz-Bravo, Adriana
Gómez-Rave, Lyz Jenny
Bermúdez, Valmore
dc.subject.eng.fl_str_mv Diabetes gestational
Thyroid disease
Pregnancy
Prevalence
topic Diabetes gestational
Thyroid disease
Pregnancy
Prevalence
Diabetes gestacional
Enfermedades de la tiroides
Embarazo
Prevalencia
dc.subject.spa.fl_str_mv Diabetes gestacional
Enfermedades de la tiroides
Embarazo
Prevalencia
description Introduction: gestational diabetes mellitus (GDM) commonly appears between the second and third trimesters of pregnancy as a result of hormonal changes that induce a transitory state of insulin resistance (IR) in the mother, allowing a greater supply of glucose to the fetus. After GDM, thyroid disease is the most common endocrine disorder in obstetrics, with an incidence of 5-10%. Some studies speak of the existence of a relationship between diabetes and thyroid disorders (TA) but the results remain controversial, limiting the analysis of the effects that both diseases could have on the development of pregnancy. Therefore, the identification of patients at risk, prevention and timely treatment, constitute one of the priority issues in public health. Objective: in this study, the prevalence of GDM and AT in pregnant women attended in a specialized center for maternal and child diagnosis was analyzed. Materials and methods: retrospective research, based on the exploration of medical records in the period from 2016 to 2020, with a probabilistic sample of 388 pregnant women (n=388). For the diagnosis of GDM, the results of the O'sullivan test, oral glucose tolerance test (OGTT) and fasting blood glucose were taken into account. Thyroid alteration was identified from TSH values, but only 120 pregnant women reported results for this test (n=120). Descriptive measures and simple frequency distributions were calculated. To establish the relationship between GDM and AT, the chi-square test was applied with a statistical significance of p=0.05. Results:the prevalence of GDM was 10.6% (n=41) and of AT 17.5% (n=21). 19% of the pregnant women simultaneously presented GDM and AT with a predominance of a tendency to hyperthyroidism. No significant association was found between GDM and AT (p=0.537). Conclusion: This pilot study confirms that GDM and AT are conditions frequently present in pregnant women. Although there could be a risk of developing GDM in patients with AT, studies with a larger sample number are suggested to clarify this relationship.
publishDate 2022
dc.date.issued.none.fl_str_mv 2022
dc.date.accessioned.none.fl_str_mv 2023-08-17T18:57:08Z
dc.date.available.none.fl_str_mv 2023-08-17T18:57:08Z
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dc.type.driver.eng.fl_str_mv info:eu-repo/semantics/article
dc.type.spa.spa.fl_str_mv Artículo científico
dc.identifier.citation.eng.fl_str_mv Jhoalmis Sierra-Castrillo, Yojanna Perdomo Dominguez, Jeferson Adrian Villamizar Carvajal, Adriana Muñoz-Bravo, Lyz Jenny Gómez-Rave, & Valmore Bermudez. (2022). Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center. https://doi.org/10.5281/zenodo.7415235
dc.identifier.issn.none.fl_str_mv 26107996
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12442/13155
dc.identifier.doi.none.fl_str_mv https://doi.org/10.5281/zenodo.7415235
identifier_str_mv Jhoalmis Sierra-Castrillo, Yojanna Perdomo Dominguez, Jeferson Adrian Villamizar Carvajal, Adriana Muñoz-Bravo, Lyz Jenny Gómez-Rave, & Valmore Bermudez. (2022). Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center. https://doi.org/10.5281/zenodo.7415235
26107996
url https://hdl.handle.net/20.500.12442/13155
https://doi.org/10.5281/zenodo.7415235
dc.language.iso.eng.fl_str_mv eng
language eng
dc.rights.*.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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dc.rights.accessrights.eng.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
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eu_rights_str_mv openAccess
dc.format.mimetype.spa.fl_str_mv pdf
dc.publisher.spa.fl_str_mv Sociedad Latinoamericana de Hipertensión
dc.source.spa.fl_str_mv Revista Latinoamericana de Hipertensión
dc.source.none.fl_str_mv Vol. 17, No. 6 (2022)
institution Universidad Simón Bolívar
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spelling Sierra-Castrillo, Jhoalmisa6ff4ce4-fc58-417d-a8e3-ac4666da8fa5Perdomo Dominguez, Yojanna2500c6f5-830d-4a7e-99ae-dcc56a09fc9eVillamizar Carvajal, Jeferson Adriáncaa1c983-f16d-4332-8fac-2730dda636ecMuñoz-Bravo, Adrianabcb8d689-8f17-45e5-8ffb-e0f03afd9f2dGómez-Rave, Lyz Jenny7d3c3858-44f5-43ef-99c4-f67e9c350e44Bermúdez, Valmore29f9aa18-16a4-4fd3-8ce5-ed94a0b8663a2023-08-17T18:57:08Z2023-08-17T18:57:08Z2022Jhoalmis Sierra-Castrillo, Yojanna Perdomo Dominguez, Jeferson Adrian Villamizar Carvajal, Adriana Muñoz-Bravo, Lyz Jenny Gómez-Rave, & Valmore Bermudez. (2022). Gestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic center. https://doi.org/10.5281/zenodo.741523526107996https://hdl.handle.net/20.500.12442/13155https://doi.org/10.5281/zenodo.7415235Introduction: gestational diabetes mellitus (GDM) commonly appears between the second and third trimesters of pregnancy as a result of hormonal changes that induce a transitory state of insulin resistance (IR) in the mother, allowing a greater supply of glucose to the fetus. After GDM, thyroid disease is the most common endocrine disorder in obstetrics, with an incidence of 5-10%. Some studies speak of the existence of a relationship between diabetes and thyroid disorders (TA) but the results remain controversial, limiting the analysis of the effects that both diseases could have on the development of pregnancy. Therefore, the identification of patients at risk, prevention and timely treatment, constitute one of the priority issues in public health. Objective: in this study, the prevalence of GDM and AT in pregnant women attended in a specialized center for maternal and child diagnosis was analyzed. Materials and methods: retrospective research, based on the exploration of medical records in the period from 2016 to 2020, with a probabilistic sample of 388 pregnant women (n=388). For the diagnosis of GDM, the results of the O'sullivan test, oral glucose tolerance test (OGTT) and fasting blood glucose were taken into account. Thyroid alteration was identified from TSH values, but only 120 pregnant women reported results for this test (n=120). Descriptive measures and simple frequency distributions were calculated. To establish the relationship between GDM and AT, the chi-square test was applied with a statistical significance of p=0.05. Results:the prevalence of GDM was 10.6% (n=41) and of AT 17.5% (n=21). 19% of the pregnant women simultaneously presented GDM and AT with a predominance of a tendency to hyperthyroidism. No significant association was found between GDM and AT (p=0.537). Conclusion: This pilot study confirms that GDM and AT are conditions frequently present in pregnant women. Although there could be a risk of developing GDM in patients with AT, studies with a larger sample number are suggested to clarify this relationship.Introducción: comúnmente la diabetes mellitus gestacio nal (DMG) suele aparecer entre el segundo y tercer trimes tre del embarazo como consecuencia de cambios hormo nales que inducen en la madre un estado transitorio de re sistencia a la insulina (IR), permitiendo un mayor aporte de glucosa al feto. Después de la DMG, la patología tiroidea es la alteración endocrina más frecuente en obstetricia, con una incidencia de 5-10%. Algunos estudios hablan de la existencia de una relación entre diabetes y alteración tiroidea (AT) pero los resultados siguen siendo controverti dos, limitando el análisis de los efectos que ambas enfer medades podrían tener en el desarrollo del embarazo. Por ello, la identificación de pacientes en riesgo, la prevención y el tratamiento oportuno, constituyen uno de los temas prioritarios en salud pública. Objetivo: en este estudio se analizó la prevalencia de DMG y de AT en gestantes aten didas en un centro especializado de diagnóstico materno infantil. Materiales y métodos: investigación retrospectiva, a partir de la exploración de historias clínicas en el periodo de 2016 al 2020, con una muestra probabilística de 388 gestantes (n=388). Para el diagnóstico de DMG se tuvier on en cuenta resultados del Test de O’sullivan, prueba de tolerancia oral a la glucosa (PTOG) y glucemia en ayunas. La alteración tiroidea se identificó a partir de valores de TSH, pero sólo 120 gestantes reportaron resultados para esta prueba (n=120). Se calcularon medidas descriptivas y distribuciones de frecuencia simple. Para establecer la relación entre DMG y AT se aplicó la prueba chi-cuadrado con una significancia estadística p=0,05. Resultados: la prevalencia de DMG fue del 10,6% (n=41) y de AT 17,5% (n=21). El 19% de las gestantes presentaron de mane ra simultánea DMG y AT con predominio de tendencia a hipertiroidismo. No se logró evidenciar asociación sig nificativa entre DMG y AT (p=0,537). Conclusión: este estudio piloto ratifica que la DMG y la AT son condiciones presentadas con frecuencia en gestantes. Aunque podría existir riesgo de desarrollo de DMG en paciente con AT, se sugieren estudios con mayor número de muestra que permitan esclarecer esta relación.pdfengSociedad Latinoamericana de HipertensiónAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Revista Latinoamericana de HipertensiónVol. 17, No. 6 (2022)Diabetes gestationalThyroid diseasePregnancyPrevalenceDiabetes gestacionalEnfermedades de la tiroidesEmbarazoPrevalenciaGestational diabetes and thyroid disorders in pregnant women in a specialized maternal-child diagnostic centerDiabetes gestacional y alteraciones tiroideas en gestantes de un centro especializado de diagnóstico materno-infantilinfo:eu-repo/semantics/articleArtículo científicohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_2df8fbb1García F. Diabetes gestacional análisis de la influencia de parámetros clínicos y ecográficos en los resultados perinatales. Fundación Dianet. Universidad Autónoma de Madrid (España) 2012Williams R. Abordaje de la diabetes mellitus gestacional. Revista Médica de Costa Rica y Centroamérica. 2015;615:367-371Di Cianni G, Miccoli R, Volpe L, et al. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev. 2003;19:259-70. Doi: https://doi.org/10.1002/dmrr.390Catalano PM. Trying to understand gestational diabetes. Diabet Med. 2014,31:273-81. Doi: 10.1111/dme.12381Yang Y, Li Q, Wang Q, Ma X. Thyroid antibodies and gestational diabetes mellitus: A meta-analysis. Fertil Steril. 2015;104(3):665-71.e3. Doi: 10.1016/j.fertnstert.2015.06.003Artega J. Diabetes gestacional. Obstetricia integral siglo XXI. Universidad Nacional de Colombia. 2011;9Castillo A. Diabetes Mellitus Gestacional: Generalidades. Revista Médica de Costa Rica y Centroamérica LXVIII. 2011;(596):109-113Yang S, Shi F, Leung P, Huang H, Fan J. Low thyroid hormone in early pregnancy is associated with an increased risk of Gestational Diabetes Mellitus. J Clin Endocrinol Metab. 2016;101(11):4237–4243. Doi: https://doi.org/10.1210/jc.2016-1506Androutsopoulos G, Gkogkos P, Decavalas G. Midtrimester maternal serum HCG and alpha fetal protein levels: clinical significance and prediction of adverse pregnancy outcome. Int J Endocrinol Metab. 2013;11:102–106. Doi: 10.5812/ijem.5014Korevaar T, Steegers E, Pop V, Broeren M, Chaker L, de Rijke Y, et al. Thyroid autoimmunity impairs the thyroidal response to hCG: two population-based prospective cohort studies. J Clin Endocrinol Metab. 2016. Doi: 10.1210/jc.2016-2942Wei Y, Yang H, Zhu W, Yang H, Li H, Yan J, Zhang C. International Association of Diabetes and Pregnancy Study Group criteria is suitable for gestational diabetes mellitus diagnosis: Further evidence from China. Chin Med J (Engl). 2014;127(20):3553-3556.Li X, Zuo J, Li Y, Tang Y, Bao Y, Ying H. Association between thyroid function and risk of gestational diabetes mellitus in assisted pregnancies: A retrospective cohort study. Diabetes Res Clin Pract. 2021;171:108590. Doi: https://doi.org/10.1016/j.diabres.2020.108590Ethridge J, Catalano P, Waters T. Perinatal outcomes associated with the diagnosis of gestational diabetes made by the international association of the diabetes and pregnancy study groups criteria. Obstet Gynecol. 2014;124(3):571-578.Doi: 10.1097/AOG.0000000000000412Jiwani A, Marseille E, Lohse N, et al. Gestational diabetes mellitus: results from a survey of country prevalence and practices. J Matern Fetal Neonatal Med. 2012;25:600-10.Doi: https://doi.org/10.3109/147670 58.2011.587921Negro R, Mestman J. Thyroid disease in pregnancy. Best Pract Res Clin Endocrinol Metab. 2011;25(6):927-943.Doi: https://doi.org/10.1016/j. beem.2011.07.010Diéguez M, Herrero A, Avello N, Suárez P, Delgado E, Menéndez E. Prevalence of thyroid dysfunction in women in early pregnancy: Does it increase with maternal age?. Clin Endocrinol (Oxf). 2016;84(1):121- 126.doi: https://doi.org/10.1111/cen.12693Glinoer D, de Nayer P, Bourdoux P, et al. Regulation of maternal thyroid during pregnancy. J Clin Endocrinol Metab. 1990, 71:276-87 Doi:10.1210/jcem-71-2-276Talat A, Khan A, Nasreen S, Wass J. Thyroid screening during early pregnancy and the need for trimester specific reference ranges: a cross-sectional study in Lahore, Pakistan. Cureus. 2019;11:e5661. Doi: 10.7759/cureus.5661Kennedy R, Darne J. The role of hCG in regulation of the thyroid gland in normal and abnormal pregnancy. Obstet Gynecol. 1991;78(2):298- 307Utiger R. Maternal hypothyroidism and fetal development. N Engl J Med. 1999,341:601-2. Doi: 10.1056/NEJM199908193410809Banovac K, Ryan E, O’Sullivan M. Triiodothyronine (T3) nuclear binding sites in human placenta and decidua. Placenta. 1986,6:543-549. Doi: 10.1016/s0143-4004(86)80140-0Shields B, Knight B, Hill A, Hattersley A, Vaidya B. Fetal thyroid hormone level at birth is associated with fetal growth. J Clin Endocrinol Metab. 2011,96:E934-8. Doi:10.1210/jc.2010-2814Pombar M, Penín M, Vélez M, Trigo C, Álvarez E, Rodríguez R. Impacto de la aplicación de los criterios de la Asociación Americana de Tiroides en el diagnóstico de hipotiroidismo en gestantes de Vigo, España. Rev Peru Med Exp Salud Publica. 2013;30(3):428-31.Jaiswal A. Thyroid dysfunction in pregnant female in tertiary care centre of chhattisgarh.Indian J Appl Res. 2022;12(1):1-2.Doi: 10.36106/ijarMaleki N, Tavosi Z. Evaluation of thyroid dysfunction and autoimmunity in gestational diabetes mellitus and its relationship with postpartum thyroiditis. Diabet Med. 2015;32(2):206-212.Doi: 10.1111/ dme.12580Tudela C, Casey B, McIntire D, Cunningham F. Relationship of subclinical thyroid disease to the incidence of gestational diabetes. Obstet Gynecol. 2012;119(5):983-988. doi: 10.1097/AOG.0b013e318250aeebBech K, Høier M, Feldt U, Jensen B, Mølsted L, Kühl C. Thyroid function and autoimmune manifestations in insulin-dependent diabetes mellitus during and after pregnancy. Acta Endocrinol (Copenh). 1991, 124:534-9. Doi: 10.1530/acta.0.1240534Weetman A. Insulin-dependent diabetes mellitus and postpartum thyroiditis: an important association. J Clin Endocrinol Metab. 1994,79:7- 9. Doi: 10.1210/jcem.79.1.8027256Ferrara A, Weiss N, Hedderson M, Quesenberry C, Selby J, Ergas I, et al. Pregnancy plasma glucose levels exceeding the American Diabetes Association thresholds, but below the National Diabetes Data Group thresholds for gestational diabetes mellitus, are related to the risk of neonatal macrosomia, hypoglycaemia and hyperbilirubinaemia. Diabetologia. 2007;50(2):298-306American Diabetes Association. Standards of Medical Care in Diabetes— 2020. Diabetes Care. 2020;43(1):S25-S31. Doi: 10.2337/dc20- SINTMcIntyre H, Sacks D, Barbour L, et al. Issues with the diagnosis and classification of hyperglycemia in early pregnancy. Diabetes Care. 2016;39:53–54. Doi: https://doi.org/10.2337/dc15-1887.Asociación Médica Mundial (AMM). Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas en seres humanosJohannes J, Rieke G. Revised CIOMS International Ethical Guidelines for Health-Related Research Involving Humans. JAMA. 2016. Doi:10.1001/jama.2016.18977República de Colombia Ministerio de Salud. Resolución Nº 008430 de 1993American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37(1):S81-90. Doi: http://doi.org/3crOrganización Panamericana de la Salud. Guías ALAD de diagnóstico, control y tratamiento de diabetes mellitus tipo 2. Washington, D.C. OPS; 2008.Cortés Y, Ocampo T, Villegas P. Prevalence of gestational diabetes mellitus in Medellin’s population from 1999 to 2000: the positive predictive value of the screening test and comparison of criteria in the NDDG and ADA. Rev Colomb Obstet Ginecol. 2002;53:81-5Hunt K, Reifsnider O, Mayorga M. Prevalence estimates of diabetes during pregnancy in United States women, 1980 to 2008. Obesity2012 30th Annual Scientific Meeting; 2012; San Antonio, Texas.Doi: https://doi.org/10.1371/journal.pone.0073437.O’Sullivan J, Mahan C. Criteria for the oral glucose tolerance test in pregnancy. Diabetes. 1964;13:278-85.Metzger B, Buchanan T, Coustan D, De Leiva A, Dunger D, Hadden D, et al. Summary and recommendations of the Fifth International Workshop- Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007;30(2):S251-60. Doi: http://doi.org/ckprpcBuchanan T, Xiang A. Gestational diabetes mellitus. J. Clin. Invest. 2005;115(3):485-91. Doi: http://doi.org/ct2t8dFrías J, Pérez C, Saavedra D. Gestational Diabetes Mellitus: a review of current diagnostic strategies concepts. Rev. Fac. Med. 2016;64(4):769- 75.Doi: https://doi.org/10.15446/revfacmed.v64n4.54569Palani S, Joseph N, Tegene Y, Zacharia A, Marew T. Gestational diabetes - A review. JGTPS. 2014;5(2):1673-83Cahoreau C, Klett D, Combarnous Y. Structure–Function Relationships of Glycoprotein Hormones and Their Subunits’ Ancestors. Frontiers in Endocrinology. 2015;6(26):1-14. Doi: 10.3389/fendo.2015.00026. Doi: 10.3389/fendo.2015.00026Grün J, Meuris S, De Nayer P, Glinoer D. The thyrotrophic role of human chorionic gonadotropin (hCG) in the early stages of twin (versus single) pregnancies. Clin Endocrinol (Oxf) (1997) 46(6):719–25. Doi: 10.1046/j.1365-2265.1997.2011011.xTsuruta E, Tada H, Tamaki H, Kashiwai T, Asahi K, Takeoka K, et al. Pathogenic role of asialo human chorionic gonadotropin in gestational thyrotoxicosis. J Clin Endocrinol Metab. 1995;80(2):350–5. Doi: 10.1210/jcem.80.2.7852489Fitzpatrick D, Russell M. Diagnosis and management of thyroid disease in pregnancy. Obstet Gynecol Clin North Am. 2010;37(2):173–93.Doi: 10.1016/j.ogc.2010.02.007.Devdhar M, Ousman Y, Burman K. Hypothyroidism. Endocrinol Metab Clin North Am. 2007;36(3):595–615González A, Avalos A, Ramírez L, Rosales J, Pichardo M, Contreras N. Incidencia de patología tiroidea durante el embarazo. Rev Invest Med Sur Mex. 2013;20(1):11-16Gyamfi C, Wapner R, D’Alton M. Thyroid dysfunction in pregnancy: the basic science and clinical evidence surrounding the controversy in management. Obstet Gynecol. 2009;113(3):702–7.Doi: 10.1097/ AOG.0b013e3181996fe5Stagnaro 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(10):1081-125. Doi: 10.1089/thy.2011.0087Das D, Bandyopadhyay D, Bandyopadhyay S, Neogi A. Thyroid hormone regulation of beta-adrenergic receptors and catecholamine sensitive adenylate cyclase in foetal heart. Acta Endocrinol (Copenh). 1984;106(4):569-576.Doi: https://doi.org/10.1530/acta.0.1060569Parham M, Asgarani F, Bagherzadeh M, Ebrahimi G, Vafaeimanesh J. Thyroid function in pregnant women with gestational diabetes: Is screening necessary?. Thyroid Res Pract. 2015;12:3-7.Doi: 10.4103/0973-0354.147271.Sahu M, Das V, Mittal S, Agarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol Obstet. 2010;281:215- 220.Doi: 10.1007/s00404-009-1105-1Tudela C, Casey B, McIntire D, Cunningham F. Relationship of subclinical thyroid disease to the incidence of gestational diabetes. Obstet Gynecol. Doi: 2012;119:983-988. 10.1097/AOG.0b013e318250aeebMannisto T, Vaarasmaki M, Pouta A, Hartikainen A, Ruokonen A, Surcel H, et al. Thyroid dysfunction and autoantibodies during pregnancy as predictive factors of pregnancy complications and maternal morbidity in later life. J Clin Endocrinol Metab. 2010;95:1084-1094. Doi: 10.1210/jc.2009-1904Gong L, HongLiu L. Relationship between hypothyroidism and the incidence of gestational diabetes: A meta-analysis. Taiwanese Journal of Obstetrics and Gynecology. 2016;55(2):171-175.Doi: https://doi. org/10.1016/j.tjog.2016.02.004Constitución Política de Colombia. Ley 1581 de 2012. 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