Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois.
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
Fertil Steril. 2018 Aug;110(3):452-458. doi: 10.1016/j.fertnstert.2018.04.026.
To determine whether an association exists between maternal antithyroid antibodies and euploid miscarriage in women with recurrent early pregnancy loss (REPL).
Observational cohort study.
Two academic medical centers.
PATIENT(S): Women seen between 2004-2015 with a history of REPL, who were euthyroid or had subclinical hypothyroidism, had maternal antithyroid antibody testing and had at least one subsequent early pregnancy loss (<10 weeks' gestation).
INTERVENTION(S): Thyroid function and antibodies were measured at consultation. Subsequent miscarriages were assessed by conventional cytogenetic analysis, and when indicated, microsatellite analysis and/or comparative genomic hybridization/single nucleotide polymorphisms were performed.
MAIN OUTCOME MEASURE(S): Determine whether maternal antithyroid antibodies are associated with euploid miscarriage.
RESULT(S): Cohort consisted of 74 subjects with REPL who had 130 subsequent early pregnancy losses. The prevalence of maternal antithyroid antibodies in the cohort was 17.6%. Mean TSH was significantly higher among subjects with maternal antithyroid antibodies. Otherwise, no significant differences in demographics were noted. When comparing types of early pregnancy losses between the two groups, a trend toward having more miscarriages than nonvisualized pregnancy losses was noted among subjects with maternal antithyroid antibodies (70% and 30%) compared with subjects without maternal antithyroid antibodies (55% and 43%). No significant difference was noted in the frequency of euploid miscarriage between subjects with and without maternal antithyroid antibodies (42% vs. 56%).
CONCLUSION(S): Our study did not demonstrate an association between euploid miscarriage and maternal antithyroid antibodies in subjects with a history of REPL. Therefore, testing or treatment in this cohort may not be warranted.
在复发性早期妊娠丢失（REPL）的女性中，确定母体抗甲状腺抗体与非整倍体流产之间是否存在关联。
观察性队列研究。
两个学术医疗中心。
2004 年至 2015 年间就诊的有 REPL 病史的女性，她们甲状腺功能正常或患有亚临床甲状腺功能减退症，进行了母体抗甲状腺抗体检测，并且至少有一次后续早期妊娠丢失（<10 周妊娠）。
在就诊时测量甲状腺功能和抗体。随后的流产通过常规细胞遗传学分析评估，并且在需要时进行微卫星分析和/或比较基因组杂交/单核苷酸多态性。
确定母体抗甲状腺抗体是否与非整倍体流产有关。
队列包括 74 例有 REPL 的患者，他们有 130 次后续早期妊娠丢失。队列中母体抗甲状腺抗体的患病率为 17.6%。有母体抗甲状腺抗体的患者的 TSH 平均值明显较高。除此之外，在人口统计学特征方面没有明显差异。当比较两组的早期妊娠丢失类型时，与无母体抗甲状腺抗体的患者相比（55%和 43%），有母体抗甲状腺抗体的患者的流产率（70%和 30%）高于非可视化妊娠丢失率。但是，有母体抗甲状腺抗体的患者和无母体抗甲状腺抗体的患者之间非整倍体流产的频率没有显著差异（42%与 56%）。
我们的研究未在有 REPL 病史的患者中显示出母体抗甲状腺抗体与非整倍体流产之间存在关联。因此，在该队列中进行检测或治疗可能没有必要。
