Thyroperoxidase and thyroglobulin antibodies in early pregnancy and placental abruption.
OBJECTIVE
To estimate the relationship between thyroid antibodies and placental abruption.


METHODS
This cohort study assesses thyroperoxidase and thyroglobulin antibodies in relation to placental abruption among 10,062 women with singleton viable pregnancies (from the First and Second Trimester Risk of Aneuploidy [FaSTER] trial). A thyroperoxidase antibody cutoff of 50 international units/mL is used for comparison with published data from another cohort.


RESULTS
Women with elevated thyroperoxidase antibody levels in the first and second trimesters have a higher rate of placental abruption than antibody-negative women. This relationship is less strong in the first trimester (1.51% compared with 0.83%; odds ratio [OR], 1.83; 95% confidence interval [CI], 0.99-3.37) than in the second trimester (1.78% compared with 0.82%; OR, 2.20; 95% CI, 1.21-3.99). A similar, but weaker, relationship is present for thyroglobulin antibodies. Sixty-four of 782 thyroperoxidase antibody-positive pregnancies without abruption become negative by the second trimester; one pregnancy with abruption becomes antibody-positive. Odds ratios for pregnancies with both thyroperoxidase and thyroglobulin antibody elevations are also higher (first trimester: OR, 2.10; 95% CI, 0.91-4.86; second trimester: OR, 2.73; 95% CI, 1.17-6.33).


CONCLUSIONS
The present data confirm an association between thyroid antibody elevations and placental abruption described in a recent report. These findings, however, do not provide support for recommending routine testing for thyroid antibodies during pregnancy.


METHODS
II.
From the Women and Infants Hospital and Alpert Medical School of Brown University, Providence, Rhode Island; Savjani Institute for Health Research, Standish, Maine; Columbia University College of Physicians and Surgeons, New York, New York; Royal College of Surgeons in Ireland, Dublin, UK; the University of Utah and Intermountain HealthCare, Salt Lake City, Utah; Swedish Medical Center, Seattle, Washington; and Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
James E
JE
Haddow
Monica R
MR
McClain
Glenn E
GE
Palomaki
Louis M
LM
Neveux
Geralyn
G
Lambert-Messerlian
Jacob A
JA
Canick
Fergal D
FD
Malone
T Flint
TF
Porter
David A
DA
Nyberg
Peter S
PS
Bernstein
Mary E
ME
D'Alton
D000037:Abruptio Placentae / Q000276:immunology*; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D013954:Thyroglobulin / Q000276:immunology*; D055815:Young Adult
D013954:Thyroglobulin; D007453:Iodide Peroxidase
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