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Erschienen in: The Journal of Obstetrics and Gynecology of India 3/2016

28.01.2015 | Original Article

Pregnancy Outcome in Euthyroid Women with Anti-Thyroid Peroxidase Antibodies

verfasst von: Aruna Meena, Pushpa Nagar

Erschienen in: The Journal of Obstetrics and Gynecology of India | Ausgabe 3/2016

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Abstract

Objective

The aim of this study was to compare pregnancy outcomes in euthyroid women who were anti-TPO Ab+ with those who were anti-TPO Ab.

Design

This observational study comprised 1,000 women in the age group of 25–35 years, having normal thyroid function tests, normotensive, non-diabetic, singleton pregnancy and attending Gyn. OPD/ANC up to 20 weeks’ gestation and those who were already in the process of abortion. anti-TPO Ab levels of >50 IU/ml were considered as anti-TPO Ab+.

Setting

This study was conducted in the SMS Medical College’s attached hospital, Jaipur from April 2012 to September 2013.

Main Outcome

The estimation of the proportion of anti-TPO Abs in the hospital-based population and the comparison of pregnancy and neonatal outcomes in anti-TPO Ab+ and Ab euthyroid women were done.

Results

The main result showed increased rates in miscarriages (13.33 vs. 2.34 %, P < 0.001), LBWs (25 vs. 5.12 %, P < 0.001), preterm deliveries [<34 weeks] (5 vs. 1.80 %, P > 0.05) in anti-TPO Ab+ women.

Conclusions

The current study revealed that anti-TPO Abs are strongly associated with miscarriage and LBW irrespective of their gestational age. However, we did not find any correlation with the other complication as found in the studies by Abbassi-Ghanavati, Negro et al.
Literatur
1.
Zurück zum Zitat Potlukova E, Potluka O, Jiskra J, et al. Age as a risk factor for AITD in pregnancy. J Clin Endocrinol Metab. 2012;97(6):1945–52.CrossRefPubMed Potlukova E, Potluka O, Jiskra J, et al. Age as a risk factor for AITD in pregnancy. J Clin Endocrinol Metab. 2012;97(6):1945–52.CrossRefPubMed
2.
Zurück zum Zitat Rushworth FH, Backos M, Rai R, et al. Prospective pregnancy outcome in untreated recurrent miscarries with thyroid autoantibodies. Hum Reprod. 2011;15:1637–9.CrossRef Rushworth FH, Backos M, Rai R, et al. Prospective pregnancy outcome in untreated recurrent miscarries with thyroid autoantibodies. Hum Reprod. 2011;15:1637–9.CrossRef
3.
Zurück zum Zitat Thangaratinam S, Tan A, Knox E, et al. Thyroid auto-antibodies are strongly associated with miscarriage and preterm birth: a meta-analysis of evidence. BMJ. 2011;342:d2616.CrossRefPubMedPubMedCentral Thangaratinam S, Tan A, Knox E, et al. Thyroid auto-antibodies are strongly associated with miscarriage and preterm birth: a meta-analysis of evidence. BMJ. 2011;342:d2616.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Gyamfi C, Wapner RJ, D’Alton ME. Thyroid dysfunction in pregnancy: the basic science and clinical evidence surrounding the controversy in management. Obstet Gynecol. 2009;113(3):702–7.CrossRefPubMed Gyamfi C, Wapner RJ, D’Alton ME. Thyroid dysfunction in pregnancy: the basic science and clinical evidence surrounding the controversy in management. Obstet Gynecol. 2009;113(3):702–7.CrossRefPubMed
6.
Zurück zum Zitat Nakamura H, Usa T, Motomura M, et al. Prevalence of interrelated autoantibodies in thyroid diseases and autoimmune disorders. J Endocrinol Invest. 2008;31(10):861–5.CrossRefPubMed Nakamura H, Usa T, Motomura M, et al. Prevalence of interrelated autoantibodies in thyroid diseases and autoimmune disorders. J Endocrinol Invest. 2008;31(10):861–5.CrossRefPubMed
7.
Zurück zum Zitat Poppe K, Velkeniers B, Glinoer D. The role of thyroid autoimmunity in fertility and pregnancy. Nat Clin Pract Endocrinol Metab. 2008;4:394–405.CrossRefPubMed Poppe K, Velkeniers B, Glinoer D. The role of thyroid autoimmunity in fertility and pregnancy. Nat Clin Pract Endocrinol Metab. 2008;4:394–405.CrossRefPubMed
8.
Zurück zum Zitat Zhong Yp, Ying Y, Wu HT, et al. Relationship between antithyroid antibody and pregnancy outcome following in vitro fertilization and embryo transfer. Int J Med Sci. 2012;9(2):121–5. doi:10.7150/ijms.3467. Zhong Yp, Ying Y, Wu HT, et al. Relationship between antithyroid antibody and pregnancy outcome following in vitro fertilization and embryo transfer. Int J Med Sci. 2012;9(2):121–5. doi:10.​7150/​ijms.​3467.
10.
Zurück zum Zitat Schmidt M, Voell M, Rahlff I, et al. Longterm follow-up of antithyroid peroxidase antibodies in patients with chronic autoimmune thyroiditis (Hashimoto’s thyroiditis) treated with levothyroxine. Thyroid. 2008;18:755–60.CrossRefPubMed Schmidt M, Voell M, Rahlff I, et al. Longterm follow-up of antithyroid peroxidase antibodies in patients with chronic autoimmune thyroiditis (Hashimoto’s thyroiditis) treated with levothyroxine. Thyroid. 2008;18:755–60.CrossRefPubMed
11.
Zurück zum Zitat Abbassi-Ghanavati M, Casey BM, Spong CY, et al . Pregnancy outcomes in women with thyroid peroxidase antibodies. Obstet Gynecol. 2010;116:381–6.CrossRefPubMed Abbassi-Ghanavati M, Casey BM, Spong CY, et al . Pregnancy outcomes in women with thyroid peroxidase antibodies. Obstet Gynecol. 2010;116:381–6.CrossRefPubMed
12.
Zurück zum Zitat Cebecauer L, Radikova Z, Rovensky J, et al. Increased prevalence and coincidence of antinuclear and antithyroid antibodies in the population exposed to high levels of polychlorinated pollutants cocktail. Endocr Regul. 2009;43:75–81.PubMed Cebecauer L, Radikova Z, Rovensky J, et al. Increased prevalence and coincidence of antinuclear and antithyroid antibodies in the population exposed to high levels of polychlorinated pollutants cocktail. Endocr Regul. 2009;43:75–81.PubMed
13.
Zurück zum Zitat McElduff A, Morris J. Thyroid function tests and thyroid autoantibodies in an unselected population of women. Int J Med Sci. 2012;9:121–5. http://www.medsci.org. McElduff A, Morris J. Thyroid function tests and thyroid autoantibodies in an unselected population of women. Int J Med Sci. 2012;9:121–5. http://​www.​medsci.​org.
14.
Zurück zum Zitat Negro R, Schwartz A, Gismondi R, et al. Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes. J Clin Endocrinol Metab. 2011;96:E920–4. doi:10.1210/jc.2011-0026.CrossRefPubMed Negro R, Schwartz A, Gismondi R, et al. Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes. J Clin Endocrinol Metab. 2011;96:E920–4. doi:10.​1210/​jc.​2011-0026.CrossRefPubMed
15.
Zurück zum Zitat Lee RH, Spencer CA, Mestman JH, et al. Free T4 immunoassays are flawed during pregnancy. Am J Obstet Gynecol. 2009;200(3):260-e1–6.CrossRef Lee RH, Spencer CA, Mestman JH, et al. Free T4 immunoassays are flawed during pregnancy. Am J Obstet Gynecol. 2009;200(3):260-e1–6.CrossRef
17.
Zurück zum Zitat Fister P, Gaberscek S, Zaletel K, et al. Thyroid function in the third trimester of pregnancy and after delivery in an area of adequate iodine intake. Int J Gynaecol Obstet. 2011;112(1):52–5.CrossRefPubMed Fister P, Gaberscek S, Zaletel K, et al. Thyroid function in the third trimester of pregnancy and after delivery in an area of adequate iodine intake. Int J Gynaecol Obstet. 2011;112(1):52–5.CrossRefPubMed
18.
Zurück zum Zitat Kennedy RL, Malabu UH, Jarrod G, et al. Thyroid function and pregnancy: before during and beyond. J Obstet Gynecol. 2010;30(8):774–83.CrossRef Kennedy RL, Malabu UH, Jarrod G, et al. Thyroid function and pregnancy: before during and beyond. J Obstet Gynecol. 2010;30(8):774–83.CrossRef
20.
Zurück zum Zitat Vestgaard M, Nielsen VR, Rasmussen AK, et al. Thyroid peroxidase antibodies in pregnant women with type 1 diabetes :impact on thyroid function, metabolic control and pregnancy outcome. Acta Obstet Gynecol Scand. 2008;87(12):1336–42.CrossRefPubMed Vestgaard M, Nielsen VR, Rasmussen AK, et al. Thyroid peroxidase antibodies in pregnant women with type 1 diabetes :impact on thyroid function, metabolic control and pregnancy outcome. Acta Obstet Gynecol Scand. 2008;87(12):1336–42.CrossRefPubMed
21.
Zurück zum Zitat Mascanfroni I, Montesinos MM, Susperreguy S, et al. Control of dendritic cell maturation and function by triiodothyronine. FASEB J. 2008;22(4):1032–42.CrossRefPubMed Mascanfroni I, Montesinos MM, Susperreguy S, et al. Control of dendritic cell maturation and function by triiodothyronine. FASEB J. 2008;22(4):1032–42.CrossRefPubMed
22.
Zurück zum Zitat Mehran L, Tohidi M, Sarvghadi F, et al. Management of thyroid peroxidase antibody euthyroid women in pregnancy: comparison of the american thyroid association and the endocrine society guidelines. J Thyroid Res. 2013;2013:6. Article ID 542692. doi:10.1155/2013/542692. Mehran L, Tohidi M, Sarvghadi F, et al. Management of thyroid peroxidase antibody euthyroid women in pregnancy: comparison of the american thyroid association and the endocrine society guidelines. J Thyroid Res. 2013;2013:6. Article ID 542692. doi:10.​1155/​2013/​542692.
23.
Zurück zum Zitat Friedrich N, Schwarz S, Thonack J, et al. Association between parity and autoimmune thyroiditis in a general female population. Autoimmunity. 2008;41:174–80.CrossRefPubMed Friedrich N, Schwarz S, Thonack J, et al. Association between parity and autoimmune thyroiditis in a general female population. Autoimmunity. 2008;41:174–80.CrossRefPubMed
24.
Zurück zum Zitat Toulis KA, Goulis DG, Venetis CA, et al. Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: a meta-analysis. Eur J Endocrinol. 2010;162(4):643–52.CrossRefPubMed Toulis KA, Goulis DG, Venetis CA, et al. Risk of spontaneous miscarriage in euthyroid women with thyroid autoimmunity undergoing IVF: a meta-analysis. Eur J Endocrinol. 2010;162(4):643–52.CrossRefPubMed
25.
Zurück zum Zitat Brix TH, Hansen PS, Kyvik KO, et al. Aggregation of thyroid autoantibodies in twins from opposite-sex pairs suggests that microchimerism may play a role in the early stages of thyroid autoimmunity. J Clin Endocrinol Metab. 2009;94:4439–43.CrossRefPubMed Brix TH, Hansen PS, Kyvik KO, et al. Aggregation of thyroid autoantibodies in twins from opposite-sex pairs suggests that microchimerism may play a role in the early stages of thyroid autoimmunity. J Clin Endocrinol Metab. 2009;94:4439–43.CrossRefPubMed
26.
Zurück zum Zitat Hodkinson CF, Simpson EE, Beattie JH, et al. Preliminary evidence of immune function modulation by thyroid hormones in healthy men and women aged 55–70 years. J Endocrinol. 2009;202(1):55–63.CrossRefPubMed Hodkinson CF, Simpson EE, Beattie JH, et al. Preliminary evidence of immune function modulation by thyroid hormones in healthy men and women aged 55–70 years. J Endocrinol. 2009;202(1):55–63.CrossRefPubMed
27.
Zurück zum Zitat Camargo RY, Tomimori EK, Neves SC, et al. Thyroid and the environment: exposure to excessive nutritional iodine increases the prevalence of thyroid disorders in Sao Paulo. Braz Eur J Endocrinol. 2008;159:293–9.CrossRef Camargo RY, Tomimori EK, Neves SC, et al. Thyroid and the environment: exposure to excessive nutritional iodine increases the prevalence of thyroid disorders in Sao Paulo. Braz Eur J Endocrinol. 2008;159:293–9.CrossRef
28.
Zurück zum Zitat Haddow JE, Cleary-Goldman J, McClain MR, et al. Thyroperoxidase and thyroglobulin antibodies in early pregnancy and preterm delivery. Obstet Gynecol. 2010;116(1):58–62.CrossRefPubMed Haddow JE, Cleary-Goldman J, McClain MR, et al. Thyroperoxidase and thyroglobulin antibodies in early pregnancy and preterm delivery. Obstet Gynecol. 2010;116(1):58–62.CrossRefPubMed
29.
30.
Zurück zum Zitat Debieve F, Duliere S, Bernard P, et al. To treat or not to treat euthyroid autoimmune disorder during pregnancy? Gynecol Obstet Invest. 2009;67:178–82.CrossRefPubMed Debieve F, Duliere S, Bernard P, et al. To treat or not to treat euthyroid autoimmune disorder during pregnancy? Gynecol Obstet Invest. 2009;67:178–82.CrossRefPubMed
31.
Zurück zum Zitat Anna L, Teresa JM, Ana C, et al. Undiagnosed thyroid dysfunction, & thyroid antibodies in Mediterranean population. Endocr J. 2010;38(3):391–6.CrossRef Anna L, Teresa JM, Ana C, et al. Undiagnosed thyroid dysfunction, & thyroid antibodies in Mediterranean population. Endocr J. 2010;38(3):391–6.CrossRef
32.
Zurück zum Zitat Shields B, Hill A, Bilous M, et al. Cigarette smoking during pregnancy is associated with alterations in maternal and fetal thyroid function. J Clin Endocrinal Metab. 2009;94(2):570–4.CrossRef Shields B, Hill A, Bilous M, et al. Cigarette smoking during pregnancy is associated with alterations in maternal and fetal thyroid function. J Clin Endocrinal Metab. 2009;94(2):570–4.CrossRef
Metadaten
Titel
Pregnancy Outcome in Euthyroid Women with Anti-Thyroid Peroxidase Antibodies
verfasst von
Aruna Meena
Pushpa Nagar
Publikationsdatum
28.01.2015
Verlag
Springer India
Erschienen in
The Journal of Obstetrics and Gynecology of India / Ausgabe 3/2016
Print ISSN: 0971-9202
Elektronische ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-014-0657-6

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