Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 5/2015

01-05-2015 | Maternal-Fetal Medicine

Effect of thyroid dysfunction and autoimmunity on pregnancy outcomes in low risk population

Authors: Pinar Kumru, Emre Erdogdu, Resul Arisoy, Oya Demirci, Aysen Ozkoral, Cem Ardic, Arif Aktug Ertekin, Sinan Erdogan, Nilufer Nihan Ozdemir

Published in: Archives of Gynecology and Obstetrics | Issue 5/2015

Login to get access

Abstract

Purpose

The objective of this study was to assess the effect of thyroid dysfunction and autoimmunity in early pregnancy on adverse pregnancy and neonatal outcome.

Methods

497 pregnant women between 10 and 12 gestational age were invited who were attending for their first antenatal visit and asked to perform blood tests for thyroid function and antithyroid peroxidase antibodies. A total of 395 women were recruited in the present study. Cases were classified into four groups according to thyroid function and anti-TPO results. The pregnancy outcomes included gestational diabetes mellitus, preeclampsia, preterm delivery, cesarean rate, small for gestational age, low birth weight.

Results

2.5-(OR 2.5, 95 % CI 1.06–5.89) and 4.8-(OR 4.85, 95 % CI 1.89–12.42) fold increase in preterm delivery was detected in groups with isolated anti-TPO positivity and subclinic hypothyroidism with anti-TPO positivity compared to reference group, respectively. No association was found between thyroid dysfunction and anti-TPO positivity with gestational diabetes, preeclampsia, cesarean rates, low birth weight and small for gestational age neonates.

Conclusion

Pregnant women with anti-TPO antibody positivity alone or with subclinic hypothyroidism were more likely to experience a spontaneous preterm delivery.
Literature
1.
go back to reference Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, Mandel SJ, Stagnaro-Green A (2007) Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 92:1–7CrossRef Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, Mandel SJ, Stagnaro-Green A (2007) Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 92:1–7CrossRef
2.
go back to reference Haddow JE, Palomaki GE, Allan WC et al (1999) Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 341:549–555CrossRefPubMed Haddow JE, Palomaki GE, Allan WC et al (1999) Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 341:549–555CrossRefPubMed
3.
go back to reference Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O (2002) Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 12:63–68CrossRefPubMed Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O (2002) Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 12:63–68CrossRefPubMed
4.
go back to reference Leung AS, Millar LK, Koonings PP, Montoro M, Mestman JH (1993) Perinatal outcome in hypothyroid pregnancies. Obstet Gynecol 81:349–353PubMed Leung AS, Millar LK, Koonings PP, Montoro M, Mestman JH (1993) Perinatal outcome in hypothyroid pregnancies. Obstet Gynecol 81:349–353PubMed
5.
go back to reference Carpenter MW, Coustan DR (1982) Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773PubMed Carpenter MW, Coustan DR (1982) Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773PubMed
6.
go back to reference Zeitlin J, Ancel PY, Saurel-Cubizolles MJ, Papiernik E (2000) The relationship between intrauterine growth restriction and preterm delivery: an empirical approach using data from a European case-control study. BJOG 107:750–758CrossRefPubMed Zeitlin J, Ancel PY, Saurel-Cubizolles MJ, Papiernik E (2000) The relationship between intrauterine growth restriction and preterm delivery: an empirical approach using data from a European case-control study. BJOG 107:750–758CrossRefPubMed
7.
go back to reference Glinoer D, Riahi M, Grun JP, Kinthaert J (1994) Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J Clin Endocrinol Metab 79:197–204PubMed Glinoer D, Riahi M, Grun JP, Kinthaert J (1994) Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J Clin Endocrinol Metab 79:197–204PubMed
8.
go back to reference Negro R, Formoso G, Mangieri T et al (2006) Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab 91:2587–2591CrossRefPubMed Negro R, Formoso G, Mangieri T et al (2006) Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab 91:2587–2591CrossRefPubMed
9.
go back to reference Karakosta P, Alegakis D, Georgiou V, Roumeliotaki T, Fthenou E, Vassilaki M, Boumpas D, Castanas E, Kogevinas M, Chatzi L (2012) Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. J Clin Endocrinol Metab 97:4464–4472CrossRefPubMed Karakosta P, Alegakis D, Georgiou V, Roumeliotaki T, Fthenou E, Vassilaki M, Boumpas D, Castanas E, Kogevinas M, Chatzi L (2012) Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. J Clin Endocrinol Metab 97:4464–4472CrossRefPubMed
10.
go back to reference Mannisto T, Vaarasmaki M, Pouta A et al (2009) Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population based cohort study. J Clin Endocrinol Metab 94:772–779CrossRefPubMed Mannisto T, Vaarasmaki M, Pouta A et al (2009) Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population based cohort study. J Clin Endocrinol Metab 94:772–779CrossRefPubMed
11.
go back to reference Haddow JE, Cleary-Goldman J, McClain MR et al (2010) Thyroperoxidase and thyroglobulin antibodies in early pregnancy and preterm delivery. Obstet Gynecol 116:58–62CrossRefPubMed Haddow JE, Cleary-Goldman J, McClain MR et al (2010) Thyroperoxidase and thyroglobulin antibodies in early pregnancy and preterm delivery. Obstet Gynecol 116:58–62CrossRefPubMed
12.
go back to reference Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A (2011) Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ 342:d261CrossRef Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A (2011) Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ 342:d261CrossRef
13.
go back to reference He X, Wang P, Wang Z, He X, Xu D, Wang B (2012) Thyroid antibodies and risk of preterm delivery: a meta-analysis of prospective cohort studies. Eur J Endocrinol 167:455–464CrossRefPubMed He X, Wang P, Wang Z, He X, Xu D, Wang B (2012) Thyroid antibodies and risk of preterm delivery: a meta-analysis of prospective cohort studies. Eur J Endocrinol 167:455–464CrossRefPubMed
14.
go back to reference Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A (2010) Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. J Clin Endocrinol Metab 95:1699–1707CrossRefPubMed Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A (2010) Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. J Clin Endocrinol Metab 95:1699–1707CrossRefPubMed
15.
go back to reference Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF 3rd, Petraglia F (2009) Inflammation and pregnancy. Reprod Sci 16:206–215CrossRefPubMed Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF 3rd, Petraglia F (2009) Inflammation and pregnancy. Reprod Sci 16:206–215CrossRefPubMed
16.
go back to reference Nakamura H, Usa T, Motomura M, Ichikawa T, Nakao K, Kawasaki E et al (2008) Prevalence of interrelated autoantibodies in thyroid diseases and autoimmune disorders. J Endocrinol Invest 31:861–865CrossRefPubMed Nakamura H, Usa T, Motomura M, Ichikawa T, Nakao K, Kawasaki E et al (2008) Prevalence of interrelated autoantibodies in thyroid diseases and autoimmune disorders. J Endocrinol Invest 31:861–865CrossRefPubMed
17.
go back to reference Colin IM, Isaac J, Dupret P, Ledant T, D’Hautcourt JL (2004) Functional lymphocyte subset assessment of the Th1/Th2 profile in patients with autoimmune thyroiditis by flowcytometric analysis of peripheral lymphocytes. J Biol Regul Homeost Agents 18:72–76PubMed Colin IM, Isaac J, Dupret P, Ledant T, D’Hautcourt JL (2004) Functional lymphocyte subset assessment of the Th1/Th2 profile in patients with autoimmune thyroiditis by flowcytometric analysis of peripheral lymphocytes. J Biol Regul Homeost Agents 18:72–76PubMed
18.
go back to reference Mascanfroni I, Montesinos MM, Susperreguy S, Cervi L, Ilarregui JM, Ramseyer VD et al (2008) Control of dendritic cell maturation and function by triiodothyronine. FASEB J 22:1032–1042CrossRefPubMed Mascanfroni I, Montesinos MM, Susperreguy S, Cervi L, Ilarregui JM, Ramseyer VD et al (2008) Control of dendritic cell maturation and function by triiodothyronine. FASEB J 22:1032–1042CrossRefPubMed
19.
go back to reference Prummel MF, Wiersinga WM (2004) Thyroid autoimmunity and miscarriage. Eur J Endocrinol 150:751–755CrossRefPubMed Prummel MF, Wiersinga WM (2004) Thyroid autoimmunity and miscarriage. Eur J Endocrinol 150:751–755CrossRefPubMed
20.
go back to reference Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A (2010) Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. J Clin Endocrinol Metab 95:44–48CrossRef Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A (2010) Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. J Clin Endocrinol Metab 95:44–48CrossRef
21.
go back to reference Su PY, Huang K, Hao JH, Xu YQ, Yan SQ, Li T, Xu YH, Tao FB (2011) Maternal thyroid function in the first twenty weeks of pregnancy and subsequent fetal and infant development: a prospective population-based cohort study in China. J Clin Endocrinol Metab 96:3234–3241CrossRefPubMed Su PY, Huang K, Hao JH, Xu YQ, Yan SQ, Li T, Xu YH, Tao FB (2011) Maternal thyroid function in the first twenty weeks of pregnancy and subsequent fetal and infant development: a prospective population-based cohort study in China. J Clin Endocrinol Metab 96:3234–3241CrossRefPubMed
22.
go back to reference Goel P, Radotra A, Devi K, Malhotra S, Aggarwal A, Huria A (2005) Maternal and perinatal outcome in pregnancy with hypothyroidism. Indian J Med Sci 59:116–117CrossRefPubMed Goel P, Radotra A, Devi K, Malhotra S, Aggarwal A, Huria A (2005) Maternal and perinatal outcome in pregnancy with hypothyroidism. Indian J Med Sci 59:116–117CrossRefPubMed
23.
go back to reference Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, Nixon A, Pearce EN, Soldin OP, Sullivan S, Wiersinga W (2011) Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 21:1081–1125CrossRefPubMedCentralPubMed Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, Nixon A, Pearce EN, Soldin OP, Sullivan S, Wiersinga W (2011) Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 21:1081–1125CrossRefPubMedCentralPubMed
24.
go back to reference De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, Eastman CJ, Lazarus JH, Luton D, Mandel SJ, Mestman J, Rovet J, Sullivan S (2012) Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 97:2543–2565CrossRefPubMed De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, Eastman CJ, Lazarus JH, Luton D, Mandel SJ, Mestman J, Rovet J, Sullivan S (2012) Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 97:2543–2565CrossRefPubMed
Metadata
Title
Effect of thyroid dysfunction and autoimmunity on pregnancy outcomes in low risk population
Authors
Pinar Kumru
Emre Erdogdu
Resul Arisoy
Oya Demirci
Aysen Ozkoral
Cem Ardic
Arif Aktug Ertekin
Sinan Erdogan
Nilufer Nihan Ozdemir
Publication date
01-05-2015
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 5/2015
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-014-3533-9

Other articles of this Issue 5/2015

Archives of Gynecology and Obstetrics 5/2015 Go to the issue