Li Yuyan, Xu Ting, Mo Qinyun, Fu Weiling, Yao Chunyan
Department of Obstetrics and Gynecology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, PR China.
Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, PR China.
Clin Biochem. 2019 Feb;64:44-48. doi: 10.1016/j.clinbiochem.2018.11.017. Epub 2018 Dec 1.
Thyroid autoantibody has been associated with adverse pregnancy outcomes. However, thyroid-receptor antibody (TRAb) has not been considered as a potential risk assessment indicator for adverse pregnancy outcomes. Therefore, we assessed the role of TRAb in evaluation of the risk of adverse pregnancy outcomes.
Pregnant women residing in Chongqing were enrolled in the study from 2012 to 2014. The TRAb, thyroid-stimulating hormone (TSH), free thyroxine (FT), and free triiodothyronine (FT) of all patients were analyzed via electrochemiluminescence assays. All data were recorded and analyzed statistically using SPSS.
A total of 468 pregnant women were included in the analysis. TRAb levels were higher in women with adverse pregnancy outcomes than those in women without adverse pregnancy outcomes. The incidence rate of pregnancy loss was significantly higher in the TRAb-positive group than that in the negative group, but this difference was not found in preterm delivery and early preterm delivery. In the logistic regression model, TRAb was an independent risk factor for pregnancy loss, but not for preterm delivery and early preterm delivery. The optimal cutoff point for TRAb was 3.53 IU/L, and the sensitivity and specificity of TRAb to assess the risk of pregnancy loss are 83.5% and 85.3%, respectively. Receiver-operating characteristic (ROC) curves revealed that TRAb was superior to the combination of TSH, FT and FT as an indicator for assessment.
TRAb as a more sensitive indicator providing valuable detection to assess the potential risk of pregnancy loss, and it can be used as an effective tool to improve the clinical management of thyroid disease in pregnant women.
甲状腺自身抗体与不良妊娠结局相关。然而，甲状腺受体抗体（TRAb）尚未被视为不良妊娠结局的潜在风险评估指标。因此，我们评估了TRAb在评估不良妊娠结局风险中的作用。
2012年至2014年纳入居住在重庆的孕妇进行研究。通过电化学发光法分析所有患者的TRAb、促甲状腺激素（TSH）、游离甲状腺素（FT）和游离三碘甲状腺原氨酸（FT）。所有数据均记录并使用SPSS进行统计学分析。
共468名孕妇纳入分析。不良妊娠结局女性的TRAb水平高于无不良妊娠结局女性。TRAb阳性组的流产发生率显著高于阴性组，但早产和早期早产未发现此差异。在逻辑回归模型中，TRAb是流产的独立危险因素，但不是早产和早期早产的危险因素。TRAb的最佳截断点为3.53 IU/L，TRAb评估流产风险的敏感性和特异性分别为83.5%和85.3%。受试者工作特征（ROC）曲线显示，TRAb作为评估指标优于TSH、FT和FT的组合。
TRAb作为一个更敏感的指标，可为评估流产的潜在风险提供有价值的检测，并且可作为改善孕妇甲状腺疾病临床管理的有效工具。
