Farname Inc. in collaboration with Iranian Society of Gynecology Oncology

Authors

1 UNIVERSITY

2 university

Abstract

 Background and Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (TPO-Ab). However, whether women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of present study was to comparison of pregnancy outcomes in pregnant women with positive and negative TPO-Ab.
Methods: This cross-sectional study was conducted on pregnant women with positive anti-TPO Ab (n= 108) and negative anti-TPO Ab (n=340) referring to Imam Khomeini Hospital and Ahvaz clinics from January 2020 to December 2020. The pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, miscarriage, preterm birth, placental abruption, IUFD, IUGR, and TSH level, were compared between the two groups by SPSS software using student t-test and Chi-square test.
Results: The mean TSH level was significantly different in women with negative TPO-Ab than those with positive TPO-Ab (Mean (SD): 2.25(1.47) vs. 4.82(9.38), P<0.0001). In addition, 81 (75.00%) women in the positive anti-TPO group and 104 (30.58%) in the negative anti-TPO group had high TSH (P<0.001). The frequency of GDM in positive anti-TPO Ab pregnant women was significantly higher than that in the negative anti-TPO Ab group (46.29% vs. 34.11%, P=0.029). The results also indicated an enhancement in the rate of miscarriage (15.74% vs. 4.11%, P<0.001) and preterm parturition (13.88% vs. 3.52%, P<0.001) in positive anti-TPO Ab women.
Conclusions: Presence of positive anti-TPO Ab was significantly associated with preterm delivery, abortion and GDM in pregnancy. Treatment with Levothyroxine can reduce the risk of adverse pregnancy outcomes in women who are positive for TPOAb.
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Keywords

  1. 1. Bhat S, AP A, AP S, Umakanth S. Effect of Thyroid Peroxidase Antibody on Pregnancy Outcome among Hypothyroid Women. Journal of Clinical & Diagnostic Research. 2018;12(8). 2. Meena M, Chopra S, Jain V, Aggarwal N. The effect of anti-thyroid peroxidase antibodies on pregnancy outcomes in euthyroid women. Journal of Clinical and Diagnostic Research: JCDR. 2016;10(9):QC04. 3. Cakmak BD, Turker UA, Temur M, Ustunyurt E. Pregnancy outcomes of antibody negative and untreated subclinical hypothyroidism. Journal of Obstetrics and Gynaecology Research. 2019;45(4):810-6. 4. Prummel MF, Wiersinga WM. Thyroid peroxidase autoantibodies in euthyroid subjects. Best practice & research Clinical endocrinology & metabolism. 2005;19(1):1-15. 5. Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, et al. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. thyroid. 2014;24(12):1670-751. 6. Lin L, Zhang X, Long Y. Analysis of thyroid peroxidase antibody in early pregnancy. Genet Mol Res. 2014;13(3):5107-14. 7. Han Y, Mao L-J, Ge X, Huang K, Yan S-Q, Ren L-L, et al. Impact of maternal thyroid autoantibodies positivity on the risk of early term birth: Ma’anshan Birth Cohort Study. Endocrine. 2018;60(2):329-38. 8. Rajput R, Yadav T, Seth S, Nanda S. Prevalence of thyroid peroxidase antibody and pregnancy outcome in euthyroid autoimmune positive pregnant women from a tertiary care center in Haryana. Indian journal of endocrinology and metabolism. 2017;21(4):577. 9. Pradhan M, Anand B, Singh N, Mehrotra M. Thyroid peroxidase antibody in hypothyroidism: it’s effect on pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine. 2013;26(6):581-3. 10. Rajput R, Goel V, Nanda S, Rajput M, Seth S. Prevalence of thyroid dysfunction among women during the first trimester of pregnancy at a tertiary care hospital in Haryana. Indian journal of endocrinology and metabolism. 2015;19(3):416. 11. Chen X, Jin B, Xia J, Tao X, Huang X, Sun L, et al. Effects of thyroid peroxidase antibody on maternal and neonatal outcomes in pregnant women in an iodine-sufficient area in China. International journal of endocrinology. 2016;2016. 12. Sert UY, Buyuk GN, Ustun YE, Erdinc ASO. Is There any relationship between thyroid function abnormalities, thyroid antibodies and development of gestational diabetes mellitus (GDM) in pregnant women? Medeniyet Medical Journal. 2020;35(3):195. 13. Safian S, Esna-Ashari F, Borzouei S. Thyroid dysfunction in pregnant women with gestational diabetes mellitus. Current Diabetes Reviews. 2020;16(8):895-9. 14. Hassani F, Movahed F, Lalouha F, Noori E. Evaluation of Thyroid Dysfunction in Women with Gestational Diabetes Mellitus Compared to Healthy Pregnant Women Referred to Kowsar Hospital in Qazvin from 2017 to 2018. Journal of Obstetrics, Gynecology and Cancer Research. 2020;5(1):6-10. 15. Gupta A, Wajdi N, Verma A, Pal MK. Role of anti-thyroid peroxidase antibodies in adverse pregnancy outcomes. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016;5(9):3001-6. 16. Netra HK, Pant R, Banerjee KP. An observational study of fetomaternal outcome in euthyroid women with anti-thyroid peroxidase antibodies at tertiary care hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020;9(6):2476-82. 17. Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A. Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. The Journal of Clinical Endocrinology & Metabolism. 2010;95(9):E44-E8. 18. Glinoer D. Miscarriage in women with positive anti-TPO antibodies: is thyroxine the answer? : Oxford University Press; 2006. p. 2500-2. 19. Negro R, Schwartz A, Stagnaro-Green A. Impact of levothyroxine in miscarriage and preterm delivery rates in first trimester thyroid antibody-positive women with TSH less than 2.5 mIU/L. The Journal of Clinical Endocrinology & Metabolism. 2016;101(10):3685-90. 20. Ghafoor F, Mansoor M, Malik T, Malik MS, Khan AU, Edwards R, et al. Role of thyroid peroxidase antibodies in the outcome of pregnancy. Journal of the College of Physicians and Surgeons--pakistan: JCPSP. 2006;16(7):468-71. 21. Taha I. Adverse pregnancy outcome in Saudi women diagnosed with overt hypothyroidism during pregnancy, with and without thyroid peroxidase antibodies. Journal of American Science. 2013;8:9. 22. Abbassi-Ghanavati M, Casey BM, Spong CY, McIntire DD, Halvorson LM, Cunningham FG. Pregnancy outcomes in women with thyroid peroxidase antibodies. Obstetrics & Gynecology. 2010;116(2):381-6. 23. He X, Wang P, Wang Z, He X, Xu D, Wang B. Thyroid antibodies and risk of preterm delivery: a meta-analysis of prospective cohort studies. Eur J Endocrinol. 2012;167(4):455-64. 24. Korevaar TI, Steegers EA, Pop VJ, Broeren MA, Chaker L, de Rijke YB, et al. Thyroid autoimmunity impairs the thyroidal response to human chorionic gonadotropin: two population-based prospective cohort studies. The Journal of Clinical Endocrinology & Metabolism. 2017;102(1):69-77. 25. Yuan N, Sun J, Li Z, Chai S, Zhang X, Ji L. Relationship between anti-thyroid peroxidase antibody positivity and pregnancy-related and fetal outcomes in Euthyroid women: a single-center cohort study. BMC Pregnancy and Childbirth. 2020;20(1):1-10. 26. Tierney K, Delpachitra P, Grossmann M, Onwude J, Sikaris K, Wallace EM, et al. Thyroid function and autoantibody status among women who spontaneously deliver under 35 weeks of gestation. Clinical endocrinology. 2009;71(6):892-5. 27. Pearce EN, Oken E, Gillman MW, Lee SL, Magnani B, Platek D, et al. Association of first-trimester thyroid function test values with thyroperoxidase antibody status, smoking, and multivitamin use. Endocrine Practice. 2008;14(1):33-9. 28. Banerjee S. Thyroid disorders in pregnancy. J Assoc Physicians India. 2011;59(Suppl):32-4. 29. Prummel MF, Wiersinga WM. Thyroid autoimmunity and miscarriage. European journal of endocrinology. 2004;150(6):751-6. 30. Abalovich M, Alcaraz G, Kleiman-Rubinsztein J, Pavlove MM, Cornelio C, Levalle O, et al. The relationship of preconception thyrotropin levels to requirements for increasing the levothyroxine dose during pregnancy in women with primary hypothyroidism. Thyroid. 2010;20(10):1175-8.