Prevalence of thyroid peroxidase antibody and pregnancy outcome in euthyroid autoimmune positive pregnant women from a tertiary care center in Haryana

Abstract

Objective:To study the prevalence of thyroid peroxidase autoantibody in euthyroid pregnant women and to evaluate the association between thyroid peroxidase autoantibody and pregnancy outcomes.Materials and Methods:One thousand thirty consecutive pregnant women attending the antenatal clinic over a period of 1 year and were carrying a healthy singleton uncomplicated intrauterine pregnancy and consuming iodized salt were recruited for the study. Outcomes of the pregnancy was compared between TPO antibody positive euthyroid women (group 1) and TPO antibody negative euthyroid women (group 2).Results:Out of 1030 women, 164 (18.9%) were detected TPO antibody positive with euthyroid status. The mean FT4 and TSH level were significantly different in those who were TPO Ab positive as compared TPO Ab negative euthyroid pregnant women. No correlation was observed between the maternal age, gestational age and gravidity with anti TPO antibody levels. Eighteen (12%) women in Group 1and 5 (3.3%) women in Group 2 had miscarriages and the difference was found to be statistically significant (P value of 0.004). Twenty-one (14%) women in Group 1 and 5 (3.3%) women in Group 2 had preterm deliveries, which was also found to be statistically significantly (p value of 0.001). Other pregnancy related complications like Intrauterine death, IUGR, preeclampsia and PIH though are present in comparatively higher number in TPO Ab positive euthyroid pregnant women as compared to TPO Ab negative euthyroid pregnant women but this difference was not found to be statistically significant.Conclusions:To conclude with the present study shows that a good number of pregnant women with euthyroid status have TPO Ab positivity and this is associated with some adverse pregnancy outcomes like miscarriage and preterm birth of the baby.

The Clinical Value and Variation of Antithyroid Antibodies during Pregnancy

“…The relevance between the abnormal elevation of TPOAbs and offspring autism has also been reported by researcher [ 88 ]. The abnormal elevation of TPOAbs has not been reported as a causal factor of parity, period of gestation, or body weight [ 71 ].…”

The Need for Dynamic Clinical Guidelines: A Systematic Review of New Research Published After Release of the 2017 ATA Guidelines on Thyroid Disease During Pregnancy and the Postpartum

“…Three studies found an association between thyroid autoimmunity and miscarriage (34)(35)(36). In a case-control study of 150 pregnant, euthyroid women with TPOAbs and 150 pregnant, euthyroid women without TPOAbs, Rajput et al reported a significant increase in miscarriage in women with TPOAbs compared to those without, 12% (18/150) vs. 3.3% (5/150), respectively, P = 0.004 (34).…”

“…"Is there an association between thyroid autoantibody positivity and premature delivery?" Four studies examined the association between thyroid autoimmunity and preterm delivery (34,(38)(39)(40), three of which were positive (34,38,40). In the study by Rajput et al TPOAb positive women had a significant increase in preterm delivery compared to TPOAb negative women, 14% (21/150) vs. 3.3% (5/150), respectively, P = 0.001 (34).…”

“…Three studies found an association between thyroid autoimmunity and miscarriage (34)(35)(36). In a case-control study of 150 pregnant, euthyroid women with TPOAbs and 150 pregnant, euthyroid women without TPOAbs, Rajput et al reported a significant increase in miscarriage in women with TPOAbs compared to those without, 12% (18/150) vs. 3.3% (5/150), respectively, P = 0.004 (34). Seungdamrong et al (35) performed a secondary analysis of 1,429 women in two RCTs, the Pregnancy in Polycystic Ovarian Syndrome II study (PPCOS II) and the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation study (AMIGOS).…”

“…Four studies examined the association between thyroid autoimmunity and preterm delivery (34,(38)(39)(40), three of which were positive (34,38,40). In the study by Rajput et al TPOAb positive women had a significant increase in preterm delivery compared to TPOAb negative women, 14% (21/150) vs. 3.3% (5/150), respectively, P = 0.001 (34). In a large prospective cohort study of 2,931 Chinese women, Han et al reported a significant association between thyroid antibody positivity in the second trimester, but not the first trimester and preterm delivery, OR 1.863, CI 1.009-3.411, and, OR 1.513, CI 0.869-2.633, respectively (38).…”