Women who suffer from preeclampsia are also at a higher risk of experiencing thyroid dysfunction
A new study, which was published in the British medical journal BMJ, examined the relationship between preeclampsia and problems with thyroid function. The study found that women who suffer from preeclampsia are also at a higher risk of experiencing problems with thyroid function. Before discussing the new study, it is important to note that the activity of the thyroid gland is fundamental to the course of life. It is responsible for the production of hormones, the most important of which affect the rate of metabolism and growth of the body.
From the new study it emerged that women who suffered from preeclampsia are at a higher risk of problems with thyroid function later in life. The data for the study was collected from two different studies. One study followed women at the end of pregnancy and the other study followed other women 20 years after they gave birth. The results of the studies show that preeclampsia has effects that remain for a long time after the disease has passed, which are manifested and appear long after the pregnancy and birth and not only during the pregnancy period itself.
It is known that the maternal thyroid hormone, thyroxine, plays an important role in the development of the fetus's brain. The fetus itself begins to produce the hormone in the second half of pregnancy, and is completely dependent on the supply of maternal thyroxine during the critical developmental stage for brain development. The level of thyroid hormones increases gradually during pregnancy until birth to meet the growing needs of the mother and the needs of the fetus. The levels of the TSH hormone also gradually increase in the fetal blood during pregnancy. During pregnancy, thyroid hormones pass from the mother's bloodstream to the fetus. The hormones of the mother's thyroid glands are important for the development of the central nervous system and the brain of the fetus in the period before the production of hormones, therefore babies of mothers whose thyroid is underactive may suffer from poor development of the nervous system. On the other hand, their fetuses do not have a normal development of the thyroid gland and there is no autonomous production of thyroid hormones, there is protection from the mother's hormones.
Preeclampsia is characterized by increased blood pressure, increased excretion of protein in the urine and severe edema. Among some women there may also be damage to other organs and systems, such as the liver, kidneys, eyes, brain as well as the blood clotting system. The disease also endangers the fetus and may cause it irreversible damage and even death.
Women with hypothyroidism that was diagnosed and treated even before pregnancy, usually need a significant addition of hormone during pregnancy. And in those cases, constant monitoring of thyroid activity is recommended from the beginning of pregnancy. In the group of women tested during pregnancy, an increase in the levels of the hormone was found towards the end of pregnancy. It was found that one out of four women had high hormone levels compared to women who did not suffer from preeclampsia in whom a high hormone level was found in only one out of seven women.
Another large-scale study, conducted in Norway and published in the scientific journal Norsk Epidemiol, examined thyroid function among women who last experienced pregnancy and childbirth about twenty years ago. The study found that women who suffered from preeclampsia in their first pregnancy were almost twice as likely to have high levels of the hormone compared to women who did not suffer from preeclampsia. It was also found that women who suffered from preeclampsia during their first and second pregnancies were six times more likely to have high hormone levels compared to women who did not suffer from preeclampsia at all. The high hormone levels found in the blood tests done for those women indicate the fact that women who suffered from preeclampsia are in a high risk group for developing diseases for a long time after giving birth and after the poisoning has passed. Hence, preeclampsia has effects and health consequences that are manifested in the long term, after the period of pregnancy and childbirth and not only during pregnancy. Diseases related to the thyroid gland are sometimes difficult to diagnose, but once diagnosed, their treatment is not complicated and even relatively simple. Overactivity of the gland causes a feeling of anxiety, weakness and difficulties in sleeping. Conversely, hypothyroidism can lead to depression, fatigue, and weight gain.
Preeclampsia is a phenomenon that characterizes about 6% of the female population in Israel and may cause the death and morbidity of the mother or the fetus. As of today, there are hypotheses regarding the causes of the disease and these studies join medical knowledge that is gradually accumulating in the hands of scientists, which points to environmental and behavioral factors that increase the risk of preeclampsia. Among the causes are anorexia, exposure to air pollution, teenage or late pregnancy and obesity. The best way to develop prevention and cure is through early detection. The earlier pre-eclampsia is detected, the greater the chances of prevention, healing and treatment, through close medical supervision and the use of food supplements or preventive drug treatment to the extent the doctor deems appropriate.
Predicting the women who are at risk at the beginning of pregnancy makes it possible to lower the risk of the disease and even to prevent it even before the symptoms appear. Through careful pregnancy monitoring, additional tests and various measures to reduce the risk of disease such as the use of food supplements such as calcium and folic acid, it is possible to increase the chances of a healthy baby developing and a normal birth. In some cases, drug treatment of low-dose aspirin or anticoagulants can be given. Sometimes the doctor can resort to active treatment to accelerate the maturation of the fetus's lungs and complete its normal development. All of these can postpone the onset of the disease, weaken its complications, reduce the harm to the fetus and in some cases even prevent it altogether. A woman's awareness of her condition can prevent catastrophic cases where the woman arrives at the hospital too late, when her life is in danger and the fetus dies in the womb.
Preeclampsia is a real life-threatening condition for the mother and is the second most important cause of death among pregnant women, as it can cause convulsions and cerebral hemorrhage. In practice, the women's mortality is not high, because in order to save their lives they give birth urgently, and the early birth is in most cases accompanied by a caesarean section and is dangerous mainly for the fetus and less so for the mother. It is often possible to save the mother but not the fetus, and if the fetus is saved, it is often born prematurely, which may suffer from low weight, underdeveloped lungs, impaired vision, motor decline, and cognitive impairment, and in addition increases the risk of the baby being born suffering from diabetes and obesity during its lifetime.
To date, dozens of methods have been proposed and studied to discover the disease before its signs appear, but the disadvantage of all of them is that the discovery is made in advanced stages of pregnancy, too late, when the ability to prevent the disease is already extremely limited. For example, a Doppler test, which is a test of the blood flow in the uterine arteries using ultrasound, a test that requires expensive equipment, high skill of the examiner, and therefore a very high cost to the health care system. Recently, a new test was developed for early prediction of the disease. This is a new blood test called a placental protein test that is performed during weeks 8-13 of pregnancy. The test allows for the first time in the world to predict the risk of an outbreak of preeclampsia 6 months later and is the product of development by an Israeli start-up company called Diagnostic Technologies. The early prediction of the disease through the new blood test is a unique and exclusive breakthrough in the world that allows the doctor to examine ways of drug treatment that can delay the onset of the disease, in other cases actually reduce its severity and even sometimes completely prevent its development.
The test is recommended for every pregnant woman. At the same time, according to scientific studies, women who are pregnant with twins or triplets, or pregnant women who are over 35 or under 18, are at increased risk of getting preeclampsia. The increased risk also exists in a first pregnancy in general or a pregnancy from a new partner, after previous pregnancies from another partner, or if the woman suffers from obesity, anorexia or diabetes.
The new test, which was developed on the basis of scientific research at the Technion, recently received the approval of the Ministry of Health and is even being marketed in Israel by the Mercury company, which has begun negotiations with the health insurance funds, in order to include it in the expanded basket of pregnancy tests of the supplementary insurances. At the same time, the Mercury company works with gynecologists, health insurance companies, insurance companies and pregnant women with the aim of increasing awareness of the disease and testing. Until the test is placed in the basket, it can be performed privately all over the country.
The author is a medical informatician with a qualified degree in life sciences and biotechnology from the University of Cambridge in England and is a member of the Mercury team
