Prevalences of Abnormal Maternal TPO-Antibodies and TSH Levels of Thai Pregnant Women in Ramathibodi Hospital
Article Sidebar
Main Article Content
Abstract
Background: Abnormal maternal thyroid function during pregnancy is associated with adverse affect to the maternal health and child development. Elevated serum thyroid stimulating hormone (TSH) in pregnant women is associated with impaired neuropsychiatric development of the child. Presence of thyroid peroxidase antibodies (TPO-Ab) is a significant risk factor for maternal postpartum thyroid disease.
Objective: This study was to determine prevalences of abnormal TSH and TPO-Ab in Thai pregnancies.
Method: Serum sample were obtained from 480 pregnant women as a part of their routine antenatal screening at Ramathibodi Hospital during August and October 2008. Measurement of TSH and TPO-Ab was done using Chemiluminescent Microparticle Immunoassay.
Results: The prevalences of abnormal TSH and TPO-Ab in Thai pregnancies were 9.79% and 13.96%, respectively. The highest frequency was found in 30.34 year-old age group. TSH abnormality was significantly associated with gestational age (P = 0.037). Abnormal TSH levels were mostly in first trimester of pregnancies.
Conclusion: Since abnormal thyroid function is common in Thai pregnancies, maternal screening of TSH and TPO-Ab should be considered.
Article Details
References
Kooistra L, Crawford S, van Baar AL, Brouwers EP, Pop VJ. Neonatal effects of maternal hypothyroxinemia during early pregnancy. Pediatrics. 2006;117(1):161-7. doi:10.1542/peds.2005-0227.
Burrow GN, Fisher DA, Larsen PR. Maternal and fetal thyroid function. N Engl J Med. 1994;331(16):1072-8. doi:10.1056/NEJM199410203311608.
Rovet JF. Congenital hypothyroidism: long-term outcome. Thyroid. 1999;9(7):741-8. doi:10.1089/thy.1999.9.741.
Blazer S, Moreh-Waterman Y, Miller-Lotan R, Tamir A, Hochberg Z. Maternal hypothyroidism may affect fetal growth and neonatal thyroid function. Obstet Gynecol. 2003;102(2):232-41.
Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105(2):239-45. doi:10.1097/01.AOG.0000152345.99421.22.
Donllay F. Auto antibodies to thyroid peroxidase in various thyroid and autoimmune disease. In Carayon P, editor. Thyroid peroxidase and thyroid autoimmunity. INSERM, 1990:285-96.
Feki M, Omar S, Menif O, Tanfous NB, Slimane H, Zouari F, et al. Thyroid disorders in pregnancy: frequency and association with selected diseases and obstetrical complications in Tunisian women. Clin Biochem. 2008;41(12):927-31. doi:10.1016/j.clinbiochem.2008.05.002.
Glinoer D, Soto MF, Bourdoux P, Lejeune B, Delange F, Lemone M, et al. Pregnancy in patients with mild thyroid abnormalities: maternal and neonatal repercussions. J Clin Endocrinol Metab. 1991;73(2):421-7. doi:10.1210/jcem-73-2-421.
Stagnaro-Green A, Roman SH, Cobin RH, el-Harazy E, Alvarez-Marfany M, Davies TF. Detection of at-risk pregnancy by means of highly sensitive assays for thyroid autoantibodies. JAMA. 1990;264(11):1422-5. doi:10.1001/jama.1990.03450110068029.
Pop VJ1, de Vries E, van Baar AL, Waelkens JJ, de Rooy HA, Horsten M, et al. Maternal thyroid peroxidase antibodies during pregnancy: a marker of impaired child development? J Clin Endocrinol Metab. 1995;80(12):3561-6. doi:10.1210/jcem.80.12.8530599.
Stagnaro-Green A. Postpartum thyroiditis. Best Pract Res Clin Endocrinol Metab. 2004;18(2):303-16. doi:10.1016/j.beem.2004.03.008.
Lazarus JH, Ammari F, Oretti R, Parkes AB, Richards CJ, Harris B. Clinical aspects of recurrent postpartum thyroiditis. Br J Gen Pract. 1997;47(418):305-8.
Ghafoor F, Mansoor M, Malik T, Malik MS, Khan AU, Edwards R, et al. Role of thyroid peroxidase antibodies in the outcome of pregnancy. J Coll Physicians Surg Pak. 2006;16(7):468-71. doi:7.2006/JCPSP.468471.
Davis LE, Leveno KJ, Cunningham FG. Hypothyroidism complicating pregnancy. Obstet Gynecol. 1988;72(1):108-12.
Leung AS, Millar LK, Koonings PP, Montoro M, Mestman JH. Perinatal outcome in hypothyroid pregnancies. Obstet Gynecol. 1993;81(3):349-53.
Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8(6):457-69.
Laurence MD, Carole AS, editors. Laboratory Medicine Practice Guidelines: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease. The National Academy of Clinical Biochemistry; 2003.
Bagis T, Gokcel A, Saygili ES. Autoimmune thyroid disease in pregnancy and the postpartum period: relationship to spontaneous abortion. Thyroid. 200111(11):1049-53. doi:10.1089/105072501753271743.
Lejeune B, Grun JP, de Nayer P, Servais G, Glinoer D. Antithyroid antibodies underlying thyroid abnormalities and miscarriage or pregnancy induced hypertension. Br J Obstet Gynaecol. 1993 ;100(7):669-72.
Iijima T, Tada H, Hidaka Y, Mitsuda N, Murata Y, Amino N. Effects of autoantibodies on the course of pregnancy and fetal growth. Obstet Gynecol. 1997;90(3):364-9.
Kurioka H, Takahashi K, Miyazaki K. Maternal thyroid function during pregnancy and puerperal period. Endocr J. 2005;52(5):587-91. doi:10.1507/endocrj.52.587.
Quinn FA, Gridasov GN, Vdovenko SA, Krasnova NA, Vodopianova NV, Epiphanova MA, et al. Prevalence of abnormal thyroid stimulating hormone and thyroid peroxidase antibody-positive results in a population of pregnant women in the Samara region of the Russian Federation. Clin Chem Lab Med. 2005;43(11):1223-6. doi:10.1515/CCLM.2005.212.
Lao TT. Thyroid disorders in pregnancy. Curr Opin Obstet Gynecol. 2005;17(2):123-7.