title: Value of combined clinical information and thyroid peroxidase antibodies in pregnancy for the prediction of postpartum thyroid dysfunction.
abstract: OBJECTIVE
  To investigate the utility of thyroid peroxidase antibodies (TPOAb) in early pregnancy combined with clinical information for prediction of postpartum thyroid dysfunction (PPTD) within 1 year postpartum.
  
  
  METHODS
  We studied 98 pregnant women by determining their TPOAb levels in early pregnancy, as well as their serum thyrotropin and free thyroid (fT4) levels at 6 and 12 months postpartum. Furthermore, they answered a questionnaire and physical examination was performed by only one examiner.
  
  
  RESULTS
  Of the 98 women, 10 were positive TPOAb in early pregnancy. The overall risk of PPTD within 1 year of follow-up was 10.2% (95% CI 4.1-16.3). Risk of PPTD was significantly higher among women with a family history of thyroid disease, TPOAb positive and presenting goiter in early pregnancy. The sensitivity, specificity and positive predictive value of TPOAb in PPTD prediction were 60.0%, 95.5% and 60%. Restricting screening to women with a family history of thyroid disease or presenting goiter increases the positive predictive value from 60% to 82.4%.
  
  
  CONCLUSIONS
  Our results suggest that TPOAb could be used as a screening test for PPTD prediction at least among women who present a high risk of developing PPTD.
authors.affiliation: Faculdade de Medicina/Serviços de Endocrinologia e Núcleo de Estudo em saúde coletiva, Hospital Universitário Clementino Fraga Filho - UFRJ, Rio de Janeiro, Brazil. drasheila@terra.com.br
authors.forename: Sheila
authors.initials: S
authors.lastname: Mamede da Costa
authors.forename: Lino
authors.initials: L
authors.lastname: Sieiro Netto
authors.forename: Claudia Medina
authors.initials: CM
authors.lastname: Coeli
authors.forename: Alexandru
authors.initials: A
authors.lastname: Buescu
authors.forename: Mario
authors.initials: M
authors.lastname: Vaisman
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D033862:Iron-Binding Proteins / Q000276:immunology*; D008403:Mass Screening / Q000379:methods*; D049590:Postpartum Period / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000276:immunology; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013959:Thyroid Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D033862:Iron-Binding Proteins; D013972:Thyrotropin; C056658:TPO protein, human; D007453:Iodide Peroxidase; D013974:Thyroxine