title: Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes.
abstract: BACKGROUND
  Thyroid antibody positivity during pregnancy has been associated with adverse outcomes including spontaneous miscarriage, recurrent miscarriage, and preterm delivery.
  
  
  OBJECTIVE
  The objective of the study was to determine whether thyroid antibody positivity in the first trimester of pregnancy in euthyroid women was associated with maternal and neonatal adverse outcomes.
  
  
  METHODS
  The present trial is a component of a prospective trial published in 2010 that evaluated screening for thyroid disease during pregnancy and the impact of levothyroxine therapy in women who were thyroid peroxidase positive with a TSH above 2.5 mIU/liter. The present study compared 14 maternal and neonatal adverse outcomes in 245 women who were euthyroid (TSH < 2.5 mIU/liter) and thyroid peroxidase positive in the first trimester to 3348 women who were euthyroid and thyroid peroxidase negative in the first trimester.
  
  
  METHODS
  The study was conducted in southern Italy at the ambulatory clinics of two community hospitals.
  
  
  METHODS
  The study consisted of 3593 women.
  
  
  METHODS
  There was no intervention.
  
  
  METHODS
  The main outcome measures were 14 maternal and neonatal complications.
  
  
  RESULTS
  The main result was an increase in very preterm delivery (<34 wk gestation at delivery) [4.5 vs. 1.8%; χ(2)(df = 1) = 8.58; P = 0.003] and respiratory distress [3.3 vs. 1.2%; χ(2)(df = 1) = 7.80; P = 0.005] in women who were thyroid antibody positive.
  
  
  CONCLUSIONS
  The present study provides further evidence of an association between thyroid antibody positivity and very preterm delivery in euthyroid women. The association with respiratory distress should be considered preliminary and awaits further study.
authors.affiliation: Division of Endocrinology , V. Fazzi Hospital, Piazza F. Muratore, 1, 73100 Lecce, Italy. robnegro@tiscali.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Negro
authors.forename: Alan
authors.initials: A
authors.lastname: Schwartz
authors.forename: Riccardo
authors.initials: R
authors.lastname: Gismondi
authors.forename: Andrea
authors.initials: A
authors.lastname: Tinelli
authors.forename: Tiziana
authors.initials: T
authors.lastname: Mangieri
authors.forename: Alex
authors.initials: A
authors.lastname: Stagnaro-Green
mesh_terms: D000022:Abortion, Spontaneous / Q000276:immunology; D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000276:immunology*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000276:immunology*; D047928:Premature Birth / Q000276:immunology; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000276:immunology; D013961:Thyroid Gland / Q000276:immunology; D013963:Thyroid Hormones / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D013963:Thyroid Hormones; D007453:Iodide Peroxidase