Anti-thyroid peroxidase antibody positivity and other obstetric complications in women with recurrent miscarriage

Authors

  • Sneha Jaiswal Department of Obstetrics and Gynecology, Medical College Kolkata, Kolkata, Bengal, India
  • Tarasankar Bag Department of Obstetrics and Gynecology, Medical College Kolkata, Kolkata, Bengal, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20164655

Keywords:

Anti-tpo antibody, Hypothyroidism, Pregnancy, Preeclampsia, Preterm Labour, Recurrent Miscarriage, TSH

Abstract

Background: Thyroid dysfunction and autoimmunity are relatively common in women of reproductive age group and has been associated with various adverse pregnancy outcomes such as recurrent miscarriage, preeclampsia and preterm labour. The aim of this study was to find out association between anti-tpo antibody and recurrent miscarriage and to evaluate obstetric complications such as preeclampsia and preterm labour in them.

Methods: This case control observational study was carried out from July 2014 to June2015 on 110 pregnant mothers out which 55 with history of recurrent miscarriage were cases and 55 without such history were controls.

Results: The mean age of the cases were 24.18 yrs. Majority of pregnancy losses occurred between 9-14wks.The prevalence of anti-tpo antibody positivity in the study population was 15.45%.out of 55 cases 12 were positive for anti-tpo antibody(21.8%).Positive anti-tpo antibody was associated with high TSH level than the negative anti tpo antibody(p<.000).The prevalence of preeclampsia and preterm labour in recurrent miscarriage patients were 9.09% and 5.45% respectively which was not significantly higher than background risk.1 out of 5 patients with preeclampsia had anti-tpo positive and none with preterm labour had anti-tpo antibody positivity.

Conclusions: The prevalence of thyroid autoimmunity was higher in patients with history recurrent miscarriage history than the control population. Even in women with biochemically normal thyroid function there was relationship between recurrent miscarriage and thyroid autoimmunity. Thus anti-tpo antibody could be risk marker for RSM. Screening for subclinical hypothyroidism (TSH >2.5 but<10) and anti-tpo antibody can be suggested as these identify women with increased risk of miscarriage.

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References

Green-top Guidelines no.17, April 2011. Available from: https://www.rcog.org.uk/globalassets/ documents/guidelines/gtg_17.pdf.

Mowbray JF, Underwood JL. Abstracts of Contributors' Individual Data Submitted to the Worldwide Prospective Observation Study on Immunotherapy for Treatment of Recurrent Spontaneous Abortion. AJRI. 1994;32:261-74.

Casey BM, Dash JS, Wells CE. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105(2):239.

Faussett MB, Branch DW. Autoimmunity and pregnancy loss. Semin Reprod Med. 2000;18:379-92.

Feki M, Omar S. Thyroid disorders in pregnancy: frequency and association with selected diseases and obstetrical complications in Tunisian women. Clinical Biochemistry. 2008;41(12):927-31.

Allan WC, Haddow JE, Palomaki GE. Maternal thyroid deficiency and pregnancy complications: implications for population screening. Journal of Medical Screening. 2000;7(3):127-30.

Stagnaro-Green A, Roman SH, Cobin RH. Detection of at risk pregnancy by means of highly sensitive assays for thyroid antibodies. J Am Med Assoc. 1990;264:1422-5.

Ticconi C, Giuliani E, Veglia M, Pietropolli A, Piccione E, Di Simone N. Thyroid autoimmunity and recurrent miscarriage. Am J Reprod Immunol. 2011;66(6):452-9.

Bagis T, Gokcel A, Saygili ES. Autoimmune thyroid disease in pregnancy and the postpartum period: relationship to spontaneous abortion. Thyroid. 2010;11:1049-53.

Abbassi-Ghanavati M, Casey B, Spong C. Pregnancy outcomes in women with thyroid peroxidase antibodies. Obstetrics Gynaecology. 2010;116(2 Pt 1):381.

Negro R, Mangieri T, Coppola L, Presicce G. Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study. Hum Reprod. 2005;20:1529-33.

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Published

2016-12-20

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Original Research Articles