title: Thyroid autoimmunity in pregnancy and its influences on maternal and fetal outcome in Iran (a prospective study).
abstract: OBJECTIVE
  Thyroid dysfunction and autoimmunity are common problems in women of child-bearing age. It could be associated with pregnancy morbidities in the mother and fetus. Due to lack of sufficient data about the prevalence of thyroid autoimmunity in pregnant women in Iran, and controversies about its complications on pregnancy outcomes, this study was conducted.
  
  
  METHODS
  This is a prospective study on 600 singleton pregnant women in 15-28 weeks of pregnancy; they were residents of Fars province. We evaluated the prevalence of preeclampsia, intra-uterine growth retardation (IUGR), preterm delivery and low Apgar score and their association with TSH, thyroid peroxidase (TPO), and thyroglobulin (Tg) antibodies.
  
  
  RESULTS
  Prevalence of anti-TPO and anti-Tg positivity is 12.8% and 8.5% among Iranian pregnant women. Mothers with either positive TPO or Tg antibody have a higher risk of preeclampsia (p = 0.019), preterm delivery (p < 0.001), IUGR (p < 0.001), and low first minute Apgar score (p < 0.001). This association was independent of thyroid dysfunction for preterm delivery (RR = 5, p < 0.001), and low Apgar score neonates (RR = 8.8, p < 0.001), but this association for preeclampsia was due to thyroid dysfunction (RR = 3.7, p = 0.003). About IUGR in either TPO or Tg positive mothers, this association results from the additive effect of thyroid dysfunction and thyroid autoimmunity (RR = 8.3, p < 0.001). Cesarean section delivery was significantly higher in abnormal TSH/positive anti-Tg mothers (p = 0.045).
  
  
  CONCLUSIONS
  Thyroid autoimmunity independent of thyroid dysfunction could have significant adverse outcomes in the mother and fetus. Further investigation should be done to reveal the significance of screening and treating the thyroid autoimmunity during pregnancy.
authors.affiliation: Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences , Shiraz , Iran .
authors.forename: Forough
authors.initials: F
authors.lastname: Saki
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dabbaghmanesh
authors.forename: Seyede Zahra
authors.initials: SZ
authors.lastname: Ghaemi
authors.forename: Sedighe
authors.initials: S
authors.lastname: Forouhari
authors.forename: Gholamhossein Ranjbar
authors.initials: GR
authors.lastname: Omrani
authors.forename: Marzieh
authors.initials: M
authors.lastname: Bakhshayeshkaram
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D015551:Autoimmunity / Q000276:immunology*; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn; D007453:Iodide Peroxidase / Q000276:immunology*; D007492:Iran; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000276:immunology; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology* / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D013954:Thyroglobulin / Q000276:immunology*; D013972:Thyrotropin / Q000276:immunology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D013972:Thyrotropin; D013954:Thyroglobulin; D007453:Iodide Peroxidase
keywords: Cesarean section; IUGR; low Apgar score; preeclampsia; pregnancy; preterm delivery; thyroid autoimmunity; thyroid dysfunction