3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic.
Endocr J. 2011;58(10):849-59. doi: 10.1507/endocrj.ej11-0026. Epub 2011 Aug 27.
The diagnostic and prognostic role of thyroid ultrasound (TUS) in pregnant women positive for antibodies to thyroperoxidase (TPOAb) is unclear. The aim of our study was to compare the relation of ultrasound thyroid texture to the thyroid laboratory tests in pregnant women and controls. Using a semi-quantitative assessment we compared TUS in two groups of women with positive TPOAb and/or with thyroid dysfunction (TSH out of 0.06-3.67 mIU/L): 186 women in 1(st) trimester of pregnancy recruited from universal screening and 67 asymptomatic age-comparable non-pregnant non-postpartum women recruited from screening of general population (controls). Women with previous history of thyroid diseases were excluded. Only 64/131 (48.9 %) of TPOAb-positive pregnant women were TUS-positive (TUS with autoimmune pattern) in comparison with 35/49 (71.4 %) TPOAb-positive controls (p <0.011). Pregnant women had more often TSH >10.0 mIU/L if they were TPOAb-positive/TUS-positive as compared to those TPOAb-positive/TUS-negative (8/64 (12.5 %) vs. 0/67 (0 %), p = 0.009). The prevalence of preterm deliveries among TPOAb-positive women was significantly lower if TPOAb-positivity was not accompanied by TUS-positivity (2/67 (3.0 %) vs. 10/64 (15.6 %) in TPOAb-positive/TUS-positive women, p = 0.028). In conclusion, nearly half of the TPOAb-positive pregnant women did not have an autoimmune pattern in TUS. Normal TUS image in TPOAb-positive pregnant women might be a protective factor for preterm delivery.
甲状腺超声（TUS）在抗甲状腺过氧化物酶抗体（TPOAb）阳性孕妇中的诊断和预后作用尚不清楚。本研究旨在比较 TPOAb 阳性和/或甲状腺功能障碍（TSH 0.06-3.67 mIU/L 以外）孕妇与对照组之间的超声甲状腺质地与甲状腺实验室检查的关系。我们使用半定量评估比较了两组 TPOAb 阳性的女性：186 名来自普遍筛查的妊娠 1 期孕妇和 67 名来自普通人群筛查的无症状年龄匹配的非妊娠非产后女性（对照组）。排除有甲状腺疾病既往史的女性。与 67 名 TPOAb 阳性对照组（71.4%）相比，仅 131 名 TPOAb 阳性孕妇（48.9%）的 TUS 阳性（具有自身免疫模式的 TUS）（p<0.011）。与 TPOAb 阳性/TUS 阴性相比，TPOAb 阳性/TUS 阳性的孕妇 TSH >10.0 mIU/L 的发生率更高（8/64（12.5%）比 0/67（0%），p=0.009）。如果 TPOAb 阳性不伴有 TUS 阳性，TPOAb 阳性孕妇的早产发生率显著降低（TPOAb 阳性/TUS 阳性组 2/67（3.0%）比 TPOAb 阳性/TUS 阳性组 10/64（15.6%），p=0.028）。总之，近一半的 TPOAb 阳性孕妇的 TUS 无自身免疫模式。TPOAb 阳性孕妇的正常 TUS 图像可能是早产的保护因素。
