Risk Factors for Postpartum Thyroid Dysfunction in Euthyroid Women Prior to Pregnancy

Abstract

Citation: Nonchev BI, Argatska AV, Pehlivanov BK, Orbetzova MM. Risk factors for postpartum thyroid dysfunction in euthyroid women prior to pregnancy. 2017;59(2):190-196. doi: 10.1515/folmed-2017-0027 Background: Thyroid dysfunction is common during the postpartum and the predisposing factors for its development are considered specifi c for the population studied. The aim of this study was to evaluate the risk factors for the occurrence of postpartum thyroid dysfunction (PPTD) in euthyroid women prior to pregnancy. Materials and methods: Forty-fi ve women with PPTD and 55 age-matched euthyroid postpartum women from Plovdiv, Bulgaria were included in the study. TSH, FT4, FT3, TPOAb, TgAb, TRAb were measured and ultrasound evaluation of the thyroid was performed in the fi rst trimester of pregnancy and during the postpartum. Results: The study found higher risk of developing PPTD in women with family history of thyroid disease (OR 4.42; 95% CI 1.87,10.43), smokers (OR 4.01; 95% CI 1.72,9.35), personal history of autoimmune thyroid disease (OR 5.37; 95% CI 1.15,28.53), positive TPOAb (OR 18.12; 95% CI 4.93,66.65) and thyroid US hypoechogenicity during early pregnancy (OR 6.39; 95% CI 2.53,16.12) and those who needed levothyroxine during pregnancy (OR 3.69; 95% CI 1.28,10.61). BMI before pregnancy was signifi cantly lower in women with PPTD than in euthyroid postpartum women (22.80±0.55 vs 26.25±0.97, p=0.013). The multivariate logistic regression analysis identifi ed as most important independent risk factors for PPTD occurrence the TPOAb positivity during early pregnancy, family history of thyroid disease, smoking and lower BMI before pregnancy. Conclusion: Our data suggest that in the population studied several factors are associated with an increased risk of PPTD and screening for thyroid disorders among those women can be benefi cial. Folia Medica BACKGROUND

Vitamin D categories and postpartum thyroid function in women with hypothyroidism

“…Advanced age, family history of thyroid diseases, and positive thyroid autoantibody were considered high risk factors for postpartum OH in women with newly diagnosed SCH during pregnancy ( 7 , 9 , 10 ). Recently, one study found that the positive TPOAb in pregnancy and 6 weeks postpartum were high risk factors for persistent hypothyroidism after delivery ( 8 ).…”