The association of antithyroid antibodies in euthyroid nonpregnant women with recurrent first trimester abortions in the next pregnancy.
OBJECTIVE
To evaluate the prognostic value of antithyroid antibodies in euthyroid women with a history of recurrent first trimester abortions on future pregnancy loss.


METHODS
The sera of 42 euthyroid women with a history of three or more consecutive first trimester abortions were evaluated for the presence of antibodies to thyroglobulin and thyroid peroxidase before pregnancy and again as soon as the diagnosis of pregnancy was made.


METHODS
Medical school-affiliated private infertility center.


METHODS
Forty-two women with a history of three or more consecutive first trimester abortions who were planning to conceive again.


METHODS
The presence of antithyroid antibodies in the nonpregnant state and their association with pregnancy loss in the next gestation.


RESULTS
Thirteen of 42 women (31%) were positive for the presence of antithyroid antibodies at the initial screening before pregnancy. All 13 maintained positivity by the time their next pregnancy was diagnosed. Only 12 of those 42 women (29%) experienced a first trimester abortion. Eight of these 12 women (67%) were positive for one or more antithyroid antibody. In contrast, among 30 nonaborting women, only 5 of 30 (17%) exhibited thyroid antibody positivity. The detection of thyroid antibodies before conception carried an increased risk of pregnancy loss in the next pregnancy (8 of 13, 62% versus 4 of 29, 14%).


CONCLUSIONS
The presence of antithyroid antibodies in nonpregnant women with a history of recurrent abortion identifies a subgroup of women at significantly increased risk for yet another pregnancy loss in their next gestation. Because organ-specific autoantibodies thus demonstrate similar prognostic significance to nonorgan-specific autoantibodies, it is tempting to conclude that peripheral autoantibody abnormalities seen in habitual aborters only reflect an underlying T-lymphocyte defect, which may be the actual cause of pregnancy loss.
Pratt
D E
DE
Center for Human Reproduction, Chicago, Illinois 60610.
Kaberlein
G
G
Dudkiewicz
A
A
Karande
V
V
Gleicher
N
N
D000026:Abortion, Habitual / Q000276:immunology*; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D006801:Humans; D011247:Pregnancy; D013954:Thyroglobulin / Q000276:immunology*
D001323:Autoantibodies; C056626:thyroid microsomal antibodies; D013954:Thyroglobulin