Autoimmune thyroid disease in pregnancy and the postpartum period: relationship to spontaneous abortion.
The aim of this study was to determine the prevalence of autoimmune thyroid disease and the risk of miscarriage in autoimmune thyroid antibody (ATA)-positive women. Eight hundred seventy-six subjects completed the study, and 12.3% were thyroid antibody-positive (4.5% tested positive for both thyroid peroxidase antibody [TPO-Ab] and thyroglobulin autoantibody [Tg-Ab], 4.79% were TPO-Ab-positive only, and 3.1% were Tg-Ab-positive only). Fifty percent of the ATA-positive women and 14.1% of the ATA-negative group had a history of spontaneous abortion. Forty-eight of the ATA-positive women developed postpartum autoimmune thyroid dysfunction (PATD). Of these, 50% had hypothyroidism alone, 31.3% had transient hyperthyroidism followed by hypothyroidism, and 18.8% had transient thyrotoxicosis alone. Of the 48 PATD subjects, 12.5% developed persistent hypothyroidism. None of the ATA-negative women developed any form of thyroid dysfunction. The thyroid-stimulating hormone (TSH) levels in the ATA-positive group were significantly higher than those in the ATA-negative group, and only the ATA-positive women with a history of abortion had significantly higher TSH and lower free thyroxine (FT4) concentrations than the other subgroups. The results revealed a 5.5% prevalence rate for PATD in the study population. In addition to TPO-Ab, Tg-Ab is a useful marker for autoimmune thyroiditis.
Bagis
T
T
Department of Gynecology and Obstetrics, Yuregir Adana, Turkey.
Gokcel
A
A
Saygili
E S
ES
D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology / Q000378:metabolism; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011446:Prospective Studies; D013954:Thyroglobulin / Q000378:metabolism; D013960:Thyroid Function Tests; D013967:Thyroiditis, Autoimmune / Q000150:complications* / Q000453:epidemiology; D014421:Turkey / Q000453:epidemiology
D013954:Thyroglobulin; D007453:Iodide Peroxidase