Thyroperoxidase and thyroglobulin antibodies in early pregnancy and preterm delivery.
OBJECTIVE
To further evaluate the relationship between thyroid antibodies and preterm births.


METHODS
This is a prospective study of pregnancy outcome and demographic data combined with retrospective measurement of thyroperoxidase and thyroglobulin antibodies. Sera were obtained at 11-13 and 15-18 weeks of gestation from 10,062 women with singleton viable pregnancies (a subset from the First- and Second-Trimester Risk of Aneuploidy [FaSTER] trial).


RESULTS
Women with elevated levels of thyroperoxidase, thyroglobulin antibodies, or both in the first trimester have a higher rate of preterm delivery before 37 weeks of gestation than antibody-negative women (7.5% compared with 6.4%, odds ratio [OR] 1.18; 95% confidence interval [CI] 0.95-1.46). This is also the case for very preterm delivery before 32 weeks of gestation (1.2% compared with 0.7%, OR 1.70; 95% CI 0.98-2.94). Preterm premature rupture of membranes is also increased (2.0% compared with 1.2%, OR 1.67; 95% CI 1.05-2.44). These associations are less strong for second-trimester antibody measurements.


CONCLUSIONS
The present data do not confirm strong associations between thyroid antibody elevations and preterm birth found in three of five previously published reports. Preterm premature rupture of membranes appears to contribute to the thyroid antibody-associated early deliveries, possibly as a result of inflammation.


METHODS
II.
Haddow
James E
JE
From the Women and Infants Hospital and Alpert Medical School of Brown University, Providence, Rhode Island; the Savjani Institute for Health Research, Standish, Maine; Columbia University College of Physicians and Surgeons, New York, New York; the Royal College of Surgeons in Ireland, Dublin, Ireland; the University of Utah and Intermountain HealthCare, Salt Lake City, Utah; the Swedish Medical Center, Seattle, Washington; and Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
Cleary-Goldman
Jane
J
McClain
Monica R
MR
Palomaki
Glenn E
GE
Neveux
Louis M
LM
Lambert-Messerlian
Geralyn
G
Canick
Jacob A
JA
Malone
Fergal D
FD
Porter
T Flint
TF
Nyberg
David A
DA
Bernstein
Peter S
PS
D'Alton
Mary E
ME
D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000276:immunology; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D047928:Premature Birth / Q000209:etiology*; D011446:Prospective Studies; D012189:Retrospective Studies
D001323:Autoantibodies; C006606:anti-thyroglobulin; D007453:Iodide Peroxidase