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来自哈里亚纳邦一家三级护理中心的甲状腺功能正常的自身免疫阳性孕妇中甲状腺过氧化物酶抗体的患病率及妊娠结局

Prevalence of Thyroid Peroxidase Antibody and Pregnancy Outcome in Euthyroid Autoimmune Positive Pregnant Women from a Tertiary Care Center in Haryana.

作者信息

Rajput Rajesh, Yadav Tekchand, Seth Shashi, Nanda Smiti

机构信息

Department of Endocrinology and Medicine Unit V, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.

Department of Biochemistry, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.

出版信息

Indian J Endocrinol Metab. 2017 Jul-Aug;21(4):577-580. doi: 10.4103/ijem.IJEM_397_16.

Abstract

OBJECTIVE

To study the prevalence of thyroid peroxidase autoantibody in euthyroid pregnant women and to evaluate the association between thyroid peroxidase autoantibody and pregnancy outcomes.

MATERIALS AND METHODS

One thousand thirty consecutive pregnant women attending the antenatal clinic over a period of 1 year and were carrying a healthy singleton uncomplicated intrauterine pregnancy and consuming iodized salt were recruited for the study. Outcomes of the pregnancy was compared between TPO antibody positive euthyroid women (group 1) and TPO antibody negative euthyroid women (group 2).

RESULTS

Out of 1030 women, 164 (18.9%) were detected TPO antibody positive with euthyroid status. The mean FT4 and TSH level were significantly different in those who were TPO Ab positive as compared TPO Ab negative euthyroid pregnant women. No correlation was observed between the maternal age, gestational age and gravidity with anti TPO antibody levels. Eighteen (12%) women in Group 1and 5 (3.3%) women in Group 2 had miscarriages and the difference was found to be statistically significant ( value of 0.004). Twenty-one (14%) women in Group 1 and 5 (3.3%) women in Group 2 had preterm deliveries, which was also found to be statistically significantly (p value of 0.001). Other pregnancy related complications like Intrauterine death, IUGR, preeclampsia and PIH though are present in comparatively higher number in TPO Ab positive euthyroid pregnant women as compared to TPO Ab negative euthyroid pregnant women but this difference was not found to be statistically significant.

CONCLUSIONS

To conclude with the present study shows that a good number of pregnant women with euthyroid status have TPO Ab positivity and this is associated with some adverse pregnancy outcomes like miscarriage and preterm birth of the baby.

摘要

目的

研究甲状腺功能正常的孕妇中甲状腺过氧化物酶自身抗体的患病率,并评估甲状腺过氧化物酶自身抗体与妊娠结局之间的关联。

材料与方法

选取连续1年内在产前门诊就诊、怀有单胎健康且无并发症的宫内妊娠并食用加碘盐的1030名孕妇进行研究。比较甲状腺过氧化物酶(TPO)抗体阳性的甲状腺功能正常女性(第1组)和TPO抗体阴性的甲状腺功能正常女性(第2组)的妊娠结局。

结果

在1030名女性中,有164名(18.9%)被检测出TPO抗体阳性且甲状腺功能正常。与TPO抗体阴性的甲状腺功能正常孕妇相比,TPO抗体阳性者的平均游离甲状腺素(FT4)和促甲状腺激素(TSH)水平存在显著差异。未观察到母亲年龄、孕周和妊娠次数与抗TPO抗体水平之间存在相关性。第1组中有18名(12%)女性和第2组中有5名(3.3%)女性发生流产,差异具有统计学意义(P值为0.004)。第1组中有21名(14%)女性和第2组中有5名(3.3%)女性发生早产,这也具有统计学意义(P值为0.001)。与TPO抗体阴性的甲状腺功能正常孕妇相比,其他与妊娠相关的并发症,如宫内死亡、胎儿生长受限、先兆子痫和妊娠高血压,虽然在TPO抗体阳性的甲状腺功能正常孕妇中出现的数量相对较多,但差异无统计学意义。

结论

本研究表明,相当数量的甲状腺功能正常的孕妇存在TPO抗体阳性,这与流产和早产等一些不良妊娠结局相关。

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