Association between thyroid function tests and anti-thyroid peroxidase (TPO) antibodies in pregnancy

Excerpt

Anti-thyroid peroxidase (TPO) antibodies are self-developed antibodies that target the membrane-associated hemoglycoprotein, thyroid peroxidase, of the thyroid cells. They are markers of thyroid autoimmunity and are commonly performed in the work-up of Hashimoto thyroiditis (TPO antibodies prevalence: 90 %) and Grave’s disease (TPO antibodies prevalence: 60–80 %). In patients with subclinical hypothyroidism, the finding of TPO antibodies confers an increased risk of progression to overt hypothyroidism. In pregnancy, the presence of TPO antibodies are associated with adverse outcomes, including miscarriage, preterm delivery, subfertility, perinatal mortality, large for gestational age and low birth weight infants and post-partum thyroiditis [1]. A recent meta-analysis has shown that elevated TPO antibodies in pregnant women are associated with significantly increased risk of preterm birth (odds ratio 2.07) and miscarriage (odds ratio 1.80 in case–control studies; odds ratio 3.90 in cohort studies) [2]. The precise mechanism underlying these complications is unclear at present and is an area of research of great activity. …