Association Between Thyroid Autoantibodies and Miscarriage and Preterm Birth

Thangaratinam, Shakila; Tan, Alex; Knox, Ellen; Kilby, Mark; Franklyn, JA

doi:10.1097/01.aoa.0000414067.82440.e6

Cited by 14 publications

(17 citation statements)

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“…2 Thangaratinam et al reported a strong association of TPO-Ab positivity with poor obstetric outcomes, for both miscarriage and preterm birth. 6 The incidence of SGA/IUGR in our study group was higher than in control group, 23.3% and 18.1% respectively, however the difference was not statistically significant, p=0.47. These observations are similar to those of Ghanavati et al, Mannisto et al and Negro et al 1,18,19 However, Ijima and colleagues reported increased rate of SGA in euthyroid TPO positive women when compared to controls, 7.1% and 3.4%, respectively.…”

Section: Association Of Tpo-ab Positivity With Foeto-maternal Outcomecontrasting

confidence: 57%

“…1,16 In a systematic review and metaanalyses of published literature by Thangaratinam et al the reported prevalence of TPO-Ab in euthyroid pregnant women varied between 5.4% and 31%. 6 In nearly 18.61% of thyroid peroxidase antibody positive women in our study, the TSH levels at term/delivery had crossed the upper limit of the euthyriod range (>5.2µml/l) as compared with thyroid peroxidase antibody negative women, the difference was statistically significant, p=0.02. Glinoer et al found that the progression of pregnant women to subclinical hypothyroidism can be predicted by the serum TSH levels and TPO-Ab titres in the first trimester.…”

Section: Discussionmentioning

confidence: 52%

“…Other theories proposed for adverse pregnancy outcome include cross-reactivity of antithyoid antibodies with HCG receptors on zona pellucida and increased cytokine levels in the endometrium. [6][7][8][9] There are no guidelines on routine testing of TPO-Ab in euthyroid pregnant women. Few authors have shown positive pregnancy outcome in euthyroid TPO-Ab positive women when treated with levothyroxine.…”

Section: Introductionmentioning

confidence: 99%

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Thyroid peroxidase antibody positivity among euthyroid pregnant women and its association with foeto-maternal outcome

Gulati¹,

Sharma²,

Bharti³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Thyroid peroxidase antibody (TPO-Ab) positivity is associated with increased risk of adverse pregnancy outcomes. The present study was planned to find out the prevalence of TPO-Ab and its association with adverse foeto-maternal outcome in euthyroid pregnant women.Methods: A total of 510 euthyroid pregnant women with <20 weeks gestation were recruited from antenatal clinic. Serum TPO-Ab testing was done and women were divided into 2 groups. The study group comprised of TPO-Ab positive women and control group comprised of age and parity matched TPO-Ab negative women, double in number to that of the study group. Repeat Serum TSH was done at term/delivery and women were followed till delivery for foeto-maternal outcome.Results: The prevalence of TPO-Ab positivity in euthyroid pregnant women was 11.3%. A significant number of women in the study group developed hypothyroidism at term/delivery, 18.61% vs 7.61%, respectively, p=0.02. None of the women in the study or control group developed gestational diabetes or placental abruption, or had babies with NND or RDS. There was one IUD in the study group, rest of the maternal and foetal outcomes studied were not statistically significant between two the groups. The caesarean section rates in both groups was not statistically different, however, there were more caesarean sections done for foetal distress in the study group, p=0.04.Conclusions: Thyroid peroxidase positivity is present in 11.3% of euthyroid women and is associated with an increased risk of developing hypothyroidism during pregnancy. It is not associated with adverse foeto-maternal outcome.

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Section: Association Of Tpo-ab Positivity With Foeto-maternal Outcomecontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Thyroid peroxidase antibody positivity among euthyroid pregnant women and its association with foeto-maternal outcome

Gulati¹,

Sharma²,

Bharti³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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show abstract

“…The systemic review and meta-analysis by Thagiratinam 12 showed a positive association of pregnancy loss with thyroid antibodies with a incidence of 17-33%. In our study we had an incidence of 5.71%, whereas others have found that it is of no greater incidence than normal control.…”

mentioning

confidence: 99%

Abnormal Thyroid Function and Recurrent Pregnancy Loss

Shrestha

Chawla

2014

Nepal j. obstet. gynaecol.

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Aims:The aim of our study was to observe the benefit of screening for thyroid function amongst women with recurrent pregnancy loss and effect of treatment for thyroid disorder on pregnancy outcome. Methods:This was a longitudinal study conducted from June 2012 to December 2013. One hundred and three patients with recurrent pregnancy loss without features of thyroid disorder were included. They were investigated for thyroid stimulating hormone (TSH), free tri iodothyronin (FT 3 ), free thyroxine (FT 4 ) levels and for auto-antibodies against thyroperoxidase (anti TPO). The patients with abnormal TSH levels were treated with thyroxine depending on the level of TSH.Results: TSH, FT 3 , FT 4 and anti TPO levels were measured. Amongst 103 ladies, thirty-eight (36.89%) had high levels of TSH. Thirty-five (33.98%) of them underwent test for anti TPO, of which two (5.71%) had autoimmune thyroiditis. Nine (8.73%) out of 103 had high FT 4 levels. Ladies with diagnosis of hypothyroidism underwent treatment and 17 (44.73%) out of 38 had conceived. Conclusions:Of 103 women with recurrent pregnancy loss, abnormal thyroid function was detected in 47. Seventeen (44.73%) of them with increased TSH level conceived after treatment with thyroxine, which gives a positive message that hypothyroidism is a treatable cause for recurrent pregnancy loss.

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“…8 Finally, TAI per se has been associated with an increased risk of premature birth, miscarriage and perinatal mortality. 8,9 Though causality remains unclear, the association of TAI with adverse pregnancy outcomes has been attributed to impaired thyroid function in the presence of TAI, co-existence of other autoimmune diseases and direct action of thyroid auto-antibodies on the reproductive tissues, such as ovary, endometrium and placenta. 10 Despite this association between hypothyroidism/ TAI and adverse pregnancy outcome, little is known about the thyroid parameters that can predict such an outcome.…”

mentioning

confidence: 99%