Chauhan Vivek, Thakur Anurag, Sharma Gurudutt
Department of Medicine, Dr. RPGMC, Kangra, Tanda, Himachal Pradesh, India.
Int J Crit Illn Inj Sci. 2018 Jan-Mar;8(1):41-43. doi: 10.4103/IJCIIS.IJCIIS_43_17.
Fetal microchimerism during pregnancy and abortion has been linked with autoimmune hypothyroidism in females. We conducted a case-control study to investigate the odds of "abortion in the past" in the newly diagnosed hypothyroid females compared to their age-matched euthyroid controls.
All consecutive newly diagnosed hypothyroid females, over 1 year, were enrolled as cases. Age-matched euthyroid controls were selected from the same region. The exposure variable tested was "past history of abortion (elective or therapeutic)."
Totally, 120 cases and 172 controls were recruited over 1 year with a mean age of 42.2 ± 9.8 years and 41.1 ± 12.4 years, respectively. The exposure variable (abortion) was present in 71 (59%) cases and 10 (6%) controls. Odds ratio (OR): 23.5 (12.2-48.9) < 0.0001. Autoimmunity, based on thyroid peroxidase (TPO) positivity (TPO levels ≥30 U/ml), was present in 92 (77%) of the cases; TPO was negative in 28 (33%) of cases. The exposure variable was documented in 62.4% and 50% of TPO positive and negative cases, respectively ( = 0.28).
The study suggests that abortion (elective or therapeutic) in the past is strongly associated with newly diagnosed hypothyroidism in females aged 42.2 ± 9.8 years; OR: 23.5 ( < 0.0001). Interestingly, abortion was associated with both, TPO positive and negative hypothyroidism.
孕期和流产期间的胎儿微嵌合体与女性自身免疫性甲状腺功能减退有关。我们进行了一项病例对照研究，以调查新诊断的甲状腺功能减退女性与年龄匹配的甲状腺功能正常对照相比，“既往流产史”的几率。
连续1年以上新诊断的甲状腺功能减退女性均纳入病例组。年龄匹配的甲状腺功能正常对照从同一地区选取。所测试的暴露变量为“既往流产史（选择性或治疗性）”。
1年期间共招募了120例病例和172名对照，平均年龄分别为42.2±9.8岁和41.1±12.4岁。71例（59%）病例和10例（6%）对照存在暴露变量（流产）。比值比（OR）：23.5（12.2 - 48.9）<0.0001。基于甲状腺过氧化物酶（TPO）阳性（TPO水平≥30 U/ml）的自身免疫在92例（77%）病例中存在；28例（33%）病例中TPO为阴性。暴露变量在TPO阳性和阴性病例中的记录分别为62.4%和50%（P = 0.28）。
该研究表明，既往流产（选择性或治疗性）与42.2±9.8岁女性新诊断的甲状腺功能减退密切相关；OR：23.5（<0.0001）。有趣的是，流产与TPO阳性和阴性的甲状腺功能减退均有关。
