Increased fetal abortion rate in autoimmune thyroid disease is related to circulating TPO autoantibodies in an autoimmune thyroiditis animal model

Lee, Yin Lau; Ng, Hang Pong; Lau, Kam Shing; Liu, Wei Min; O, Wai Sum; Yeung, William S.B.; Kung, A. W. C.

doi:10.1016/j.fertnstert.2008.07.1704

Cited by 69 publications

(57 citation statements)

References 30 publications

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“…As the zona pellucida and thyroid tissue seem to share similar antigens, the zona pellucida may in turn be a target for anti-thyroid antibodies. Findings in a murine model were in agreement by showing that anti-thyroid antibodies were detected on the surface of preimplantation embryos [76].…”

Section: Cross-reactivity With Zona Pellucida E the Ovarian Follicle supporting

confidence: 63%

Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

Twig

Shina

Amital

et al. 2012

Journal of Autoimmunity

179

111

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Section: Cross-reactivity With Zona Pellucida E the Ovarian Follicle supporting

confidence: 63%

Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

Twig

Shina

Amital

et al. 2012

Journal of Autoimmunity

179

111

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“…Although a clear association has been made between thyroid antibodies and abortion, it does not prove causality. Three research groups have demonstrated a possible mechanism through increased fetal resorption in an active immunization murine model with either Tg or TPO antibodies (188)(189)(190).…”

Section: Stagnaro-green Et Almentioning

confidence: 99%

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

Alexander

Pearce

Brent

et al. 2017

Thyroid

1,997

2,892

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INTRODUCTION Pregnancy has a profound impact on the thyroid gland and thyroid function. The gland increases 10% in size during pregnancy in iodine-replete countries and by 20%-40% in areas of iodine deficiency. Production of thyroxine (T 4 ) and triiodothyronine (T 3 ) increases by 50%, along with a 50% increase in the daily iodine requirement. These physiological changes may result in hypothyroidism in the later stages of pregnancy in iodine-deficient women who were euthyroid in the first trimester. The range of thyrotropin (TSH), under the impact of placental human chorionic gonadotropin (hCG), is decreased throughout pregnancy with the lower normal TSH level in the first trimester being poorly defined and an upper limit of 2.5 mIU/L. Ten percent to 20% of all pregnant women in the first trimester of pregnancy are thyroid peroxidase (TPO) or thyroglobulin (Tg) antibody positive and euthyroid. Sixteen percent of the women who are euthyroid and positive for TPO or Tg antibody in the first trimester will develop a TSH that exceeds 4.0 mIU/L by the third trimester, and 33%-50% of women who are positive for TPO or Tg antibody in the first trimester will develop postpartum thyroiditis. In essence, pregnancy is a stress test for the thyroid, resulting in hypothyroidism in women with limited thyroidal reserve or iodine deficiency, and postpartum thyroiditis in women with underlying Hashimoto's disease who were euthyroid prior to conception.Knowledge regarding the interaction between the thyroid and pregnancy/the postpartum period is advancing at a rapid pace. Only recently has a TSH of 2.5 mIU/L been accepted as the upper limit of normal for TSH in the first trimester. This has important implications in regards to interpretation of the literature as well as a critical impact for the clinical diagnosis of hypothyroidism. Although it is well accepted that overt hypothyroidism and overt hyperthyroidism have a deleterious impact on pregnancy, studies are now focusing on the potential impact of subclinical hypothyroidism and subclinical hyperthyroidism on maternal and fetal health, the association between miscarriage and preterm delivery in euthyroid women positive for TPO and/or Tg antibody, and the prevalence and long-term impact of postpartum thyroiditis. Recently completed prospective randomized studies have begun to produce critically needed data on the impact of treating thyroid disease on the mother, fetus, and the future intellect of the unborn child.It is in this context that the American Thyroid Association (ATA) charged a task force with developing clinical guidelines on the diagnosis and treatment of thyroid disease during pregnancy and the postpartum. The task force consisted of international experts in the field of thyroid disease and pregnancy, and included representatives from the ATA, Asia and Oceania Thyroid Association, Latin American Thyroid Society, American College of Obstetricians and Gynecologists, and the Midwives Alliance of North America. Inclusion of thyroidologists, obstetricians, and midwives ...

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“…The animals developed anti-TPO Abs and were allowed to mate [38 ]. The most important finding of this study was that preimplantation embryos showed anti-TPO Abs bound to the membrane of the blastomere of 8-cell to morula-stage embryos.…”

Section: The Role Of Autoimmune Thyroiditismentioning

confidence: 73%

Thyroid diseases in pregnancy

Gärtner¹

2009

Current Opinion in Obstetrics &Amp; Gynecology

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Recently, the recommended dose for iodine intake during pregnancy had been increased from 200 to 250 microg/day, because recent studies revealed that even mild-to-moderate iodine intake might affect the neuropsychological development of the child. About 5-18% of all pregnant women exhibit elevated thyroid-specific antibodies, but only 0.3% develop overt hypothyroidism and 0.1-0.4% overt hyperthyroidism. However, those pregnant women with autoimmune thyroiditis and normal thyroid function may have a restricted thyroid reserve, followed by hypothyroxinemia and/or thyroid-stimulating hormone increase during pregnancy. The incidence of miscarriage, preterm delivery and small for date offspring might be increased and probably a delayed neuropsychological development. Routine thyroid function testing at least as early as possible in all pregnant women is emphasized.

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Increased fetal abortion rate in autoimmune thyroid disease is related to circulating TPO autoantibodies in an autoimmune thyroiditis animal model

Cited by 69 publications

References 30 publications

Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

Thyroid diseases in pregnancy

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