Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study

Yuan, Ning; Sun, Jianbin; Li, Zhi; Chai, Shude; Zhang, Xiaomei; Ji, Linong

doi:10.1186/s12884-020-03176-4

Cited by 28 publications

(24 citation statements)

References 44 publications

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“…Pregnancy and fetal outcomes included gestational diabetes mellitus (GDM), spontaneous abortion (PROM), hypertensive disease during pregnancy (HDP), preterm delivery, fetal distress, low birth weight, macrosomia, and small for gestational age (SGA). These definitions of adverse pregnancy outcomes were consistent with previous studies [ 10 ].…”

Section: Methodssupporting

confidence: 90%

Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study

Zhang

Yuan

Sun

et al. 2021

Biol Trace Elem Res

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Iodine is an essential trace element for humans and the main raw material for thyroid hormone synthesis. However, the association between iodine nutritional status and adverse pregnancy outcomes in different regions remains controversial. This single-center cohort study was focused on the association between iodine nutritional status and adverse pregnancy outcomes in Beijing, China. We enrolled 726 pregnant women who were registered at the Peking University International Hospital between February 2017 and December 2019. To analyze the association between iodine nutritional status variations and adverse pregnancy outcomes, this study cohort included 390 (53.72%) participants with iodine deficiency, 206 (28.37%) with an adequate iodine level, 103 (14.19%) with a more than adequate iodine level, and 27 (3.72%) with iodine excess, according to the urinary iodine (UI) status of pregnant women. After adjusting for age, body mass index, parity, and history of spontaneous abortion, we identified iodine deficiency as a risk factor for anti-thyroid peroxidase antibody (TPOAb) positivity [odds ratio (OR), 3.646; 95% confidence interval (95% CI), 1.658–8.017], anti-thyroglobulin antibody (TGAb) positivity (OR, 3.109; 95% CI, 1.465–6.599), and thyroid autoimmunity (OR, 2.885; 95% CI, 1.539–5.407). There was a non-linear relationship between UI and the concentrations of TPOAb and TGAb (Pnon-linear < 0.05). Iodine deficiency during the first trimester is a risk factor for thyroid autoantibody positivity. The relationship between UI and the concentrations of TPOAb and TGAb follows a nearly U-shaped curve. Thus, physicians should critically consider the iodine nutritional status of pregnant women during the first trimester. Clinical Trials.gov Identifier: NCT02966405

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Section: Methodssupporting

confidence: 90%

Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study

Zhang

Yuan

Sun

et al. 2021

Biol Trace Elem Res

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“…In the FF group (n = 360), it was (0.03-3.53) mIU/L, and in the MF group (n = 342), it was (0.03-3.89) mIU/L. Gestational ages were comparable between groups: 11 (9-12) in FF vs 11 (9)(10)(11)(12) weeks in MF; P = 0.400. First-trimester FT4 reference range for the whole cohort was (10.30-18.02) pmol/L and was similar in the two study groups.…”

Section: Resultsmentioning

confidence: 90%

“…In a number of studies, the impact of some thyroid parameters on pregnancy outcomes was different according to the foetal gender ( 7 , 8 , 9 ). In the study by Zhang et al , the lowest percentiles of maternal free T4 (FT4) were associated with a higher birth weight in case of a male foetus (MF) only ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Does foetal gender influence maternal thyroid parameters in pregnancy?

Sitoris

Veltri

Kleynen

et al. 2022

European Thyroid Journal

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Objective It is unknown if foetal gender influences maternal thyroid function during pregnancy. We therefore investigated the prevalence of thyroid disorders and determined first-trimester TSH reference ranges according to gender. Methods A cross-sectional study involving 1663 women with an ongoing pregnancy was conducted. Twin and assisted pregnancies and l-thyroxine or antithyroid treatment before pregnancy were exclusion criteria. Serum TSH, free T4 (FT4) and thyroid peroxidase antibodies (TPOAb) were measured at median (interquartile range; IQR) 13 (11–17) weeks of gestation. Subclinical hypothyroidism (SCH) was present when serum TSH levels were >3.74 mIU/L with normal FT4 levels (10.29–18.02 pmol/L), and thyroid autoimmunity (TAI) was present when TPOAb were ≥60 kIU/L. Results Eight hundred and forty-seven women were pregnant with a female foetus (FF) and 816 with a male foetus (MF). In women without TAI and during the gestational age period between 9 and 13 weeks (with presumed high-serum hCG levels), median (IQR range) serum TSH in the FF group was lower than that in the MF group: 1.13 (0.72–1.74) vs 1.24 (0.71–1.98) mIU/L; P = 0.021. First-trimester gender-specific TSH reference range was 0.03–3.53 mIU/L in the FF group and 0.03–3.89 mIU/L in the MF group. The prevalence of SCH and TAI was comparable between the FF and MF group: 4.4% vs 5.4%; P = 0.345 and 4.9% vs 7.5%; P = 0.079, respectively. Conclusions Women pregnant with an MF have slightly but significantly higher TSH levels and a higher upper limit of the first-trimester TSH reference range, compared with pregnancies with a FF. We hypothesise that this difference may be related to higher hCG levels in women pregnant with a FF, although we were unable to measure hCG in this study. Further studies are required to investigate if this difference has any clinical relevance.

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“…Most of the available studies on anti TPO Ab in pregnancy and the maternal and fetal outcomes are based on women with euthyroid status where they were not treated with levothyroxine. [6][7][8][9] Whether an increased dose of levothyroxine or any other additional treatment is required in hypothyroid pregnant women with anti TPO Ab positive status is to be investigated by large studies.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anti-thyroid peroxidase antibodies in the first trimester pregnancy and its impact on maternal and fetal outcomes in a tertiary care centre in Bangalore

Shruthi¹,

Arunkumar²,

Patil³

2021

IJOGR

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: Hypothyroidism during pregnancy has an adverse effect on both mother and child. The maternal and foetal risk is higher in TPOAb (Thyroid peroxidase antibody) positive women compared to women with negative TPO Ab. The recent ATA (American Thyroid Association) guidelines recommend that pregnant women with TSH (Thyroid Stimulating Hormone) concentration above 2.5mU/L should be evaluated for TPOAb status and LT4(levothyroxine) treatment should be considered with TSH values between 2.5mU/L and 4.0mU/L only when TPOAb status is positive.: All the pregnant women booked in first trimester underwent testing for TSH levels and subsequently for anti TPO Ab if TSH levels were between 2.5-4 mIU/ml. The hospital based prevalence of women with anti TPO Ab positive status was determined. These pregnancies were followed till term and the maternal and foetal complications associated with TPO Ab positive and negative status were compared. Total of 400 pregnant women were included. The hospital prevalence of women with anti TPO antibodies in first trimester of pregnancy with TSH values between 2.5- 4 mIU/ml was found to be 23.5%. Anti TPO antibody positive status was significantly more associated with antenatal complications especially GDM and IUGR as compared to patients with anti TPO antibody negative status (47.8% v/s 23.2%, p value 0.001).: Women with TPO Ab positive status are to be vigilantly monitored for early detection and management of various antenatal complications. Determining anti TPO Ab status helps in avoiding unnecessary treatment of the women with TPO Ab negative status and TSH between 2.5-4mIU/ml.

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Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study

Cited by 28 publications

References 44 publications

Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study

Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study

Does foetal gender influence maternal thyroid parameters in pregnancy?

Prevalence of anti-thyroid peroxidase antibodies in the first trimester pregnancy and its impact on maternal and fetal outcomes in a tertiary care centre in Bangalore

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