The thyroid and pregnancy: a novel risk factor for very preterm delivery.
The major cause of neonatal mortality and morbidity is preterm delivery in general (< 37 completed weeks), and especially very preterm delivery (< 32 completed weeks). The objective of this study is to determine if either thyroid hormonal dysfunction and/or the presence of thyroid autoantibodies in the mother are associated with an increased risk of preterm and/or very preterm delivery. Data were collected prospectively and analyzed as a nested-case control study. There were 953 delivered gravidas enrolled between 1996 and 2002. Samples were collected at entry to care and stored at -70 degrees C. Cases included all women with preterm delivery (n = 124). Controls (n = 124) were randomly selected from among the 829 women who delivered at term (> 37 completed weeks). All samples were assessed for thyroid stimulating hormone, thyroperoxidase antibody, and thyroglobulin antibody. Gravidas with high thyrotropin (TSH) levels had a greater than threefold increase in risk of very preterm delivery. In some analyses, gravidas who tested positive for thyroglobulin antibody at entry to prenatal care also had a better than twofold increased risk of very preterm delivery. There were no significant associations between TSH level or thyroglobulin antibody positivity and the risk of moderately preterm delivery.
Stagnaro-Green
Alex
A
Department of Medicine, UMDNJ-New Jersey Medical School, Division of Endocrinology and Metabolism, 185 South Orange Avenue, Newark, NJ 17101-6035, USA. stagnaas@umdnj.edu
Chen
Xinhua
X
Bogden
John D
JD
Davies
Terry F
TF
Scholl
Theresa O
TO
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology; D011446:Prospective Studies; D012307:Risk Factors; D013959:Thyroid Diseases / Q000150:complications* / Q000276:immunology; D013972:Thyrotropin / Q000097:blood
D001323:Autoantibodies; D013972:Thyrotropin; D007453:Iodide Peroxidase