Association between postpartum thyroid dysfunction and thyroid antibodies and depression.

Harris, Brian; Othman, Sakinah; Davies, Jane A.; Weppner, G. J.; Richards, C. J.; Newcombe, Robert G.; Lazarus, John H.; Parkes, A. B.; Hall, R; Phillips, David I. W.

doi:10.1136/bmj.305.6846.152

Cited by 212 publications

(134 citation statements)

References 34 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…The results of Pop et al (1991), as well as the work of Harris et al (1992) and Pederson et al (1993), clearly demonstrate that thyroid dysfunction is associated with a small but signifi-cant fraction of PPD. 4 Nevertheless, in light of the strong associations of PPD with social support and infant variables, and its frequent occurrence in fathers, a strictly hormonal etiology for most cases of PPD is untenable.…”

Section: Tests Of the Defection Hypothesis For Postpartum Depressionmentioning

confidence: 90%

The Functions of Postpartum Depression

Hagen

1999

Evolution and Human Behavior

217

137

View full text Add to dashboard Cite

Evolutionary approaches to parental care suggest that parents will not automatically invest in all offspring, and they should reduce or eliminate investment in their children if the costs outweigh the benefits. Lack of paternal or social support will increase the costs born by mothers, whereas infant health problems will reduce the evolutionary benefits to be gained. Numerous studies support the correlation between postpartum depression (PPD) and lack of social support or indicators of possible infant health and development problems. PPD may be an adaptation that informs mothers that they are suffering or have suffered a fitness cost, which motivates them to reduce or eliminate investment in offspring under certain circumstances, and that may help them negotiate greater levels of investment from others. PPD also appears to be a good model for depression in general.

show abstract

Section: Tests Of the Defection Hypothesis For Postpartum Depressionmentioning

confidence: 90%

The Functions of Postpartum Depression

Hagen

1999

Evolution and Human Behavior

217

137

View full text Add to dashboard Cite

show abstract

“…Fifty percent of pregnant women positive for thyroid peroxidase antibodies (TPOAb, identical to microsomal antibodies (MsAb)), will develop PPTD (3)(4)(5)(6). PPTD is clinically characterized by symptoms associated with hyper-and/or hypothyroidism and depressive symptoms (4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Prediction of post partum thyroid dysfunction: can it be improved?

Kuijpens¹,

Pop

Vader³

et al. 1998

Eur J Endocrinol

View full text Add to dashboard Cite

Background: Screening pregnant women for thyroid peroxidase antibodies (TPOAb) to identify those at risk for post partum thyroid dysfunction (PPTD) is controversial, mainly because of the low positive predictive value (ppv) of TPOAb. Objectives: To evaluate if the ppv of TPOAb can be enhanced, either by taking into account the time of TPOAb testing, or by combining this parameter with other putative determinants of PPTD such as smoking, family history or other autoimmune diseases. Methods: A prospective study was performed in the Kempenland region (southeastern Netherlands). Three hundred and ten unselected women were visited at 12 and 32 weeks gestation and 4, 12, 20, 28 and 36 weeks post partum. Serial thyroid stimulating hormone (TSH), free thyroxine (fT 4 ) and TPOAb testing was performed. Thyroid dysfunction (TD) was defined as abnormal TSH either in combination with abnormal fT 4 (overt TD) or without abnormal fT 4 (subclinical TD). PPTD was defined as overt TD post partum. Multivariate regression analysis was performed for determining independent risk factors for PPTD. The sensitivity and specificity of TPOAb at different time points and at different concentrations were calculated and presented in receiver operating characteristic (ROC) curves. Women who had experienced PPTD were followed for 2.5-3 years. Results: Data from 291 women were available for analysis. Serum fT 4 declined during pregnancy and returned to baseline values post partum. TD in gestation was present in 23 women (7.9%): serum TSH was transiently decreased in 13 (6 had overt gestational thyrotoxicosis (2.1%)) and increased in 10 (2 had TPOAb). Both point prevalence and concentration of TPOAb decreased during gestation and returned to baseline levels within 12 weeks post partum. TD in post partum was present in 36 women (12.4%): 21 had subclinical and 15 overt TD. Out of the 15 women with overt TD (incidence of PPTD: 5.2%) 10 were positive for TPOAb (TPOAbþ); 9 had thyrotoxicosis (4 TPOAbþ), 5 hypothyroidism (5 TPOAbþ) and 1 thyrotoxicosis followed by hypothyroidism (TPOAbþ). Independent risk factors for PPTD were TPOAb (relative risk (RR) ¼ 27.2), bottle feeding (RR ¼ 11.1) and smoking habits (ever smoked: RR ¼ 3.1; women with PPTD had smoked more cigarettes for a longer period of time). The sensitivity of TPOAb testing was highest at 12 weeks gestation (0.67). The ppv of TPOAb was 0.31-0.75 (depending on time of testing and concentration), increasing slightly to 0.38-0.80 when combined with bottle feeding or smoking habits. There appeared to be an autoimmune form of PPTD in 2/3 of cases and a nonautoimmune form; women with the autoimmune form were at risk for developing permanent hypothyroidism. Conclusions: A maximum of 2/3 of PPTD cases can be predicted from the presence of TPOAb because 1/3 remained negative for TPOAb. The most appropriate time for TPOAb testing is in the first trimester of pregnancy. The combination of TPOAb testing with anamnestic determinants of PPTD does not increase ppv substantially.

show abstract

“…Punzi et al (32) reported in patients with autoimmune thyroiditis and widespread joint pain that TPOAb level was positively correlated with the number of joints affected by pain, pain scores, and ESR levels. It was reported in another study that there was no association between TPOAb level and FM symptom scores, TgAb was positively correlated with ESR levels, and there was no significant difference in ESR levels of FM patients with or without autoimmunity (7).…”

Section: Discussionmentioning

confidence: 99%

Relationship between Thyroid Autoimmunity and Depression, Quality of Life, and Disease Symptoms in Patients with Fibromyalgia and Rheumatoid Arthritis

et al. 2010

View full text Add to dashboard Cite

ÖzetAmaç: Bu çalışmada fibromiyalji (FM) ve romatoid artrit'li (RA) hastalarda, tiroid otoantikorlarının varlığı ve bu antikorlar ile depresyon, yaşam kalitesi ve hastalık semptomları arasındaki ilişki araştırıldı. Yöntem ve Gereçler: Çalışmaya 65 FM'li, 39 RA'lı kadın hasta ve 40 sağlıklı kontrol alındı. Serum serbest tiroksin (sT4), serbest triiodotironin (sT3), tirotropin (TSH), antitroglobülin (Tg Ab) ve antitiroid peroksidaz (TPOAb) düzeyleri immunometrik yöntemle değerlendirildi. Aynı zamanda demografik verileri, alkol, sigara alışkanlığı, sabah tutukluğu, ağrılı eklem bölgeleri ve eşlik eden diğer semptomların varlığı kaydedildi. Tüm hastalarda ağrı, uyku bozukluğu, yorgunluk ve sabah yorgunluğunun şiddeti sorgulandı. Yaşam kalitesini değerlendirmek için Fibromiyalji Etki Sorgulama formu (FES), depresyon varlığını değerlendirmek için Beck Depresyon Ölçeği (BDÖ) kullanıldı. Bulgular: TPOAb ve TgAb (+) olma oranı sırasıyla FM grubunda %13.8 ve %15.4, RA grubunda %2.6 ve %5.1, kontrol grubunda %5.0 ve %5.0 idi ve gruplar arasında anlamlı fark yoktu. Tiroid otoimmünitesinin (+) oluşu, FM grubunda %18.5, RA grubunda %5.1 ve kontrol grubunda %7.5 idi ve gruplar arasındaki fark anlamsızdı. VAS ile değerlendirilen yaygın ağrı, uyku bozukluğu, yorgunluk, sabah yorgunluğu ile ortalama FES ve BDÖ skoru yönünden gruplar arasında anlamlı derecede fark vardı ve en yüksek değerler FM grubuna aitti. Tiroid otoimmünitesi (+) olan FM'li hastalarda ortalama ESH, CRP, TSH düzeyi ve postmenapozal hasta oranı tiroid otoimmünitesi (-) olan FM hastalarına göre istatistiksel olarak anlamlı oranda yüksekti. Tiroid otoimmünitesi olan ve olmayan RA'lı hastalar karşılaştırıldığında iki grup arasın-da anlamlı fark saptanmadı. Abst ractObjective: The aim of this study was to evaluate the presence of thyroid autoantibodies in patients with fibromyalgia (FM) and rheumatoid arthritis (RA) and to investigate the relationship of these antibodies with depression, quality of life, and disease symptoms. Materials and Methods:Sixty-five patients with FM, 39 patients with RA, and 40 healthy controls were included in the study. Serumfree thyroxine, free triiodothyronine, thyrotropin, and anti-thyroglobulin (TgAb) and anti-thyroid peroxidase antibodies (TPOAb) were measured by immunometric assay. Sociodemographic characteristics, alcohol use, smoking status, morning stiffness, number of joints affected by pain, and presence of accompanying symptoms were recorded. All patients were questioned about the severity of pain, sleep disturbances, fatigue, and morning fatigue. The Fibromyalgia Impact Questionnaire (FIQ) was used to evaluate the quality of life and Beck Depression Inventory (BDI) was used to evaluate the presence of depression. Results:The rates of TPOAb and TgAb positivity were 13.8% and 15.4%, 2.6% and 5.1%, and 5.0% and 5.0% in the FM, RA, and control groups, respectively; there was no significant difference between the groups. Thyroid autoimmunity was noted in 18.5%, 5.1%, and 7.5% of the patients in the FM, RA, and control groups, res...

show abstract

Association between postpartum thyroid dysfunction and thyroid antibodies and depression.

Cited by 212 publications

References 34 publications

The Functions of Postpartum Depression

The Functions of Postpartum Depression

Prediction of post partum thyroid dysfunction: can it be improved?

Relationship between Thyroid Autoimmunity and Depression, Quality of Life, and Disease Symptoms in Patients with Fibromyalgia and Rheumatoid Arthritis

Contact Info

Product

Resources

About