Thyroid Peroxidase Antibodies in Early Pregnancy: Utility for Prediction of Postpartum Thyroid Dysfunction and Implications for Screening

Premawardhana, Lakdasa; Parkes, A. B.; John, Rhys; Harris, Brian; Lazarus, John H.

doi:10.1089/1050725041692828

Cited by 91 publications

(56 citation statements)

References 28 publications

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“…The elevated levels of autoantibodies against thyroperoxidase (TPOAb) and a personal history of thyroid disease increased the risk of thyroid dysfunction (65) . Based on experimental animal studies, Morreale de Escobar has shown the negative impact of insuffi cient levels of thyroid hormones during pregnancy on the growth of brain tissues (66,67) .…”

Section: Thyroid Diseases In Pregnancy -Possibilities For Screeningmentioning

confidence: 99%

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Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

Springer

Potluková²,

Límanová³

et al. 2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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The aim of general maternal-foetal care is to ensure an uncomplicated birth of a healthy baby to a healthy mother. There is a large range of screening tests used during pregnancy: for gestational diabetes, infection, rhesus-D status, thyroid dysfunction, as well as other tests. An important part of prenatal care is the screening of major aneuploidies, primarily for Down ' s syndrome. This screening is possible in either the fi rst or second trimester, or in both. Management of this type of screening is very similar around the world. Hypothyroidism can affect the psychomotor development of the child. Thyroidstimulating hormone (TSH), autoantibodies against thyroperoxidase (TPOAb), and free thyroxin (FT4) were determined within our group of 7530 pregnant women. Elevated concentrations of TSH were found in 5.1 % , suppression was found in 2.9 % and 11.5 % were TPOAb positive. Either a familial or personal history of thyroid or autoimmune diseases was present in 58.3 % of those women who tested positive on any thyroid test. At minimum, 40 % of women TPOAb positive during pregnancy have some kind of thyroid disorders after delivery. These results support the effi cacy of general thyroid function screening in early pregnancy, as well as the follow-up after delivery of those women who are positive.

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Section: Thyroid Diseases In Pregnancy -Possibilities For Screeningmentioning

confidence: 99%

“…The presence of TPOAb during pregnancy also alerts the medical professional to the risk of development of postpartum thyroiditis (65) ; therefore, it is necessary to follow-up on those women. TPOAb positivity may endanger not only the current, but also subsequent pregnancies.…”

Section: Thyroid Diseases In Pregnancy -Possibilities For Screeningmentioning

confidence: 99%

Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

Springer

Potluková²,

Límanová³

et al. 2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…In view of the association between anti-TPO and pregnancy loss and the usefulness of anti-TPO in predicting postpartum thyroiditis, it would also be appropriate to consider anti-TPO in any thyroid screening. 42,43 Neck ultrasound. Although scintigraphy scans are contraindicated during pregnancy and rarely needed these days anyway, routine ultrasound may be considered when a goiter or nodular disease is suggested by clinical history and examination.…”

Section: 26mentioning

confidence: 99%

Autoimmune Thyroid Disease in Pregnancy: A Review

Galofré

Davies

2009

Journal of Women's Health

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The maternal physiological changes that occur in normal pregnancy induce complex endocrine and immune responses. During a normal pregnancy, thyroid gland volume may enlarge, and thyroid hormone production increases. Hence, the interpretation of thyroid function during gestation needs to be adjusted according to pregnancy-specific ranges. The elevated prevalence of gestation-related thyroid disorders (10%-15%) and the important repercussions for both mother and fetus reported in multiple studies throughout the world denote, in our opinion, the necessity for routine thyroid function screening both before and during pregnancy. Once thyroid dysfunction is suspected or confirmed, management of the thyroid disorder necessitates regular monitoring in order to ensure a successful outcome. The aim of treating hyperthyroidism in pregnancy with antithyroid drugs is to maintain serum thyroxine (T 4 ) in the upper normal range of the assay used with the lowest possible dose of drug, whereas in hypothyroidism, the goal is to return serum thyroid-stimulating hormone (TSH) to the range between 0.5 and 2.5 mU=L.

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“…At present TPOAb is generally recommended as an useful prognostic factor for development of PPTD [5][6][7][8][9] and particularly fi rst-trimester TPOAb titers showing positive predictive value in assessing the risk of postpartum thyroid disorders. 10 In our study the presence of TPOAb in early pregnancy proved to be a signifi cant prognostic factor for the occurrence of PPTD.…”

Section: Resultsmentioning

confidence: 99%

Risk Factors for Postpartum Thyroid Dysfunction in Euthyroid Women Prior to Pregnancy

et al. 2017

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Citation: Nonchev BI, Argatska AV, Pehlivanov BK, Orbetzova MM. Risk factors for postpartum thyroid dysfunction in euthyroid women prior to pregnancy. 2017;59(2):190-196. doi: 10.1515/folmed-2017-0027 Background: Thyroid dysfunction is common during the postpartum and the predisposing factors for its development are considered specifi c for the population studied. The aim of this study was to evaluate the risk factors for the occurrence of postpartum thyroid dysfunction (PPTD) in euthyroid women prior to pregnancy. Materials and methods: Forty-fi ve women with PPTD and 55 age-matched euthyroid postpartum women from Plovdiv, Bulgaria were included in the study. TSH, FT4, FT3, TPOAb, TgAb, TRAb were measured and ultrasound evaluation of the thyroid was performed in the fi rst trimester of pregnancy and during the postpartum. Results: The study found higher risk of developing PPTD in women with family history of thyroid disease (OR 4.42; 95% CI 1.87,10.43), smokers (OR 4.01; 95% CI 1.72,9.35), personal history of autoimmune thyroid disease (OR 5.37; 95% CI 1.15,28.53), positive TPOAb (OR 18.12; 95% CI 4.93,66.65) and thyroid US hypoechogenicity during early pregnancy (OR 6.39; 95% CI 2.53,16.12) and those who needed levothyroxine during pregnancy (OR 3.69; 95% CI 1.28,10.61). BMI before pregnancy was signifi cantly lower in women with PPTD than in euthyroid postpartum women (22.80±0.55 vs 26.25±0.97, p=0.013). The multivariate logistic regression analysis identifi ed as most important independent risk factors for PPTD occurrence the TPOAb positivity during early pregnancy, family history of thyroid disease, smoking and lower BMI before pregnancy. Conclusion: Our data suggest that in the population studied several factors are associated with an increased risk of PPTD and screening for thyroid disorders among those women can be benefi cial. Folia Medica BACKGROUND

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Thyroid Peroxidase Antibodies in Early Pregnancy: Utility for Prediction of Postpartum Thyroid Dysfunction and Implications for Screening

Cited by 91 publications

References 28 publications

Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

Recommendations on prenatal screening and the connections to other diseases such as thyroid dysfunction

Autoimmune Thyroid Disease in Pregnancy: A Review

Risk Factors for Postpartum Thyroid Dysfunction in Euthyroid Women Prior to Pregnancy

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