An observational study of fetomaternal outcome in euthyroid women with anti-thyroid peroxidase antibodies at tertiary care hospital

Abstract

Background: Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction, especially if complicated by the presence of thyroid antibodies. The presence of TPO-Ab is associated with increased rate of pregnancy complications such as miscarriage, preterm delivery, placental abruption, pregnancy-induced hypertension, intrauterine death and low birth weight. Objective of this study was to study the effect of anti-TPO Ab positivity on pregnancy outcome and estimate the prevalence of anti-TPO Ab in euthyroid obstetric women.Methods: This observational study enrolled 500 euthyroid pregnant women, age 20-35 years, up to 20 weeks gestation. Venous blood samples collected and analyzed for the anti TPO Ab levels. On the basis of anti TPO Ab positivity they were divided into two groups, anti-TPO Ab positive and Ab negative group. These two groups were followed up till delivery or abortion and compared for maternal and fetal outcomes.Results: Prevalence of anti-TPO antibody positivity was 5.2% in euthyroid obstetric women. Most of anti-TPO Ab positive women were overweight. There were higher numbers of miscarriage (11.54%) in anti-TPO Ab positive euthyroid pregnancies than (2.53%) in antibody negative women. Incidence of low birth weight babies was 4-fold higher in anti-TPO Ab positive women. More than two-fold increase in incidence of placental abruption in anti-TPO Ab positive women. Parity, anaemia, gestational hypertension, preeclampsia, GDM, PROM, PPH, low Apgar scores, NICU admission, IUD and neonatal death were not significantly associated with anti-TPO Ab positivity.Conclusions: Anti TPO Ab positivity significantly associated with pre-pregnancy BMI, miscarriage rates and low birth weight of newborns.