title: Pregnancy outcomes with thyroxine replacement for subclinical hypothyroidism: Role of thyroid autoimmunity.
abstract: OBJECTIVE
  To study pregnancy outcomes in relation to thyroid peroxidase antibody (TPOAb) status with optimum thyroxine replacement for subclinical hypothyroidism.
  
  
  METHODS
  Ninety-eight women with subclinical hypothyroidism were followed up until the end of their pregnancy. TPO antibody status was performed for 59 women (positive 20, negative 39). Levothyroxine was supplemented to maintain TSH between 0.3-3 mIU/l in all patients, irrespective of TPOAb status. Pregnancy outcomes were noted as pregnancy-induced hypertension (PIH), antepartum or postpartum hemorrhage, preterm delivery, and spontaneous abortion. Outcomes were compared between 3 groups as per TPO antibody status (positive, negative, and undetermined), which were matched for age and gestational period.
  
  
  RESULTS
  Thyroid autoimmunity was noted in 34% of women screened for TPO antibody. A total of 11 adverse pregnancy outcomes were recorded (4 spontaneous abortions, 4 preterm deliveries, 3 PIH) with no significant difference between the groups.
  
  
  CONCLUSIONS
  Adverse pregnancy outcomes were not different in the 3 groups with adequate thyroxine replacement for pregnant women with subclinical hypothyroidism targeting TSH in euthyroid range, irrespective of thyroid autoimmunity status.
authors.affiliation: Department of Endocrinology, Medwin Hospital, Hyderabad, India.
authors.forename: Muthukrishnan
authors.initials: M
authors.lastname: Jayaraman
authors.forename: Abhyuday
authors.initials: A
authors.lastname: Verma
authors.forename: K V S
authors.initials: KV
authors.lastname: Harikumar
authors.forename: Meena
authors.initials: M
authors.lastname: Ugale
authors.forename: Kirtikumar
authors.initials: K
authors.lastname: Modi
keywords: Pregnancy; subclinical hypothyroidism; thyroid autoimmunity