A Long-Term Follow-Up of Postpartum Thyroiditis

Abstract

S U M M A R YTo investigate the long-term outcome of postpartum thyroiditis (PPT), 43 patients with PPT and 171 control women were evaluated 3.5 (range 2-4) years postpartum. Ten (23%) PPT patients were hypothyroid compared to none of the controls (Pc0.001). Factors associated with the development of hypothyroidism were high antimicrosomal antibody titre measured at 16 weeks gestation (P<O*Ol), severity of hypothyroid phase of PPT, multiparity, and a previous history of spontaneous abortion. The presence of microsomal antibody but no PPT in one pregnancy did not prevent the occurrence of PPT in the next pregnancy in two patients and a further five patients had PPT in two successive pregnancies. There was no association between HLA haplotype, family history of thyroid disease, smoking or frequency of oral contraception, and the development of long-term hypothyroidism after PPT. It is concluded that permanent hypothyroidism is an important sequel to PPT and patients with PPT should be followed up appropriately.

Thyroid Dysfunction in the Recently Pregnant: Postpartum Thyroiditis

“…The risk of recurrence in subsequent pregnancies is about 25%. Long-term follow-up of these women is important because permanent hypothyroidism is an important sequel, particularly in women with high titers of microsomal antibody (20,21). TREATMENT Since the signs and symptoms of postpartum thyroiditis are usually mild and transient, specific therapy is usually not indicated (18).…”

Changes suggestive of post‐partum thyroiditis in women with established hypothyroidism: incidence and predictors

“…9 Of those women diagnosed with PPT, a significant number will eventually go on to develop permanent hypothyroidism. [10][11][12][13][14] It is well documented that women with hypothyroidism prior to pregnancy require increased doses of levothyroxine during pregnancy. 15 However, only one study has specifically examined post-partum levothyroxine dosing in this population.…”

The thyroid and pregnancy

“…The usual pattern of PPT is hyperthyroidism followed by transient hypothyroidism with subsequent recovery. However, up to 40% of women with PP hypothyroidism develop permanent thyroid failure (Lazarus & Othman 1991) and of those with transient disease about one quarter become hypothyroid three to four years later (Othman et al 1990a).…”