Ekka Shreyasi C, Sinha Mani Bhushan K, Kumari Anita
Department of Physiology, Sheikh Bhikhari Medical College, Hazaribag, Jharkhand, India.
Department of Physiology, RIMS, Ranchi, Jharkhand, India.
J Family Med Prim Care. 2024 Nov;13(11):4916-4925. doi: 10.4103/jfmpc.jfmpc_485_24. Epub 2024 Nov 18.
Anti-thyroid antibodies not only cause thyroid dysfunction but have independent adverse outcomes in the fetus and mother during pregnancy and after birth. Chronic lymphocytic thyroiditis as a presentation of immune system deregulation may be associated with a generalized activation of the immune system at the fetus-maternal unit, the placenta. This interference could be associated with pregnancy morbidities in m o t h e r a n d fetus. This study was done to find out the frequency of autoimmune thyroid disease and its effect on maternal and fetal outcomes in a tertiary care facility in Jharkhand.
This is an Observational Prospective Study done during an 18-month period on 254 pregnant women in their second trimester who came to the antenatal clinic (ANC) clinic with singleton pregnancy at RIMS Ranchi.
222 (87.4%) out of the 254 pregnant women had anti- TPO antibodies less than 35 IU/ml. Anti-thyroid peroxidase (anti-TPO) antibody positivity with values greater than 35 IU/ml was found in 32 patients (12.6%). Anti-TPO antibody mean value was 22.54 ± 19.67 IU/ml. Among the 222 individuals who tested negative for the anti-TPO antibody, 7 (3.3%) had miscarriages, 182 (88.3%) gave birth vaginally, and 33 (14.9%) underwent a cesarean section. Of the 32 individuals who tested positive for the anti-TPO antibody, 2 (6.3%) had miscarriages, 24 (75.0%) had vaginal deliveries, and 6 (18.8%) had cesarean sections. Using the Chi-square test, a value of 0.549 was calculated, indicating statistical insignificance (Pearson Chi-square test value = 0.200).
Anti-TPO antibody positivity was significantly related to miscarriage and anemia. Other complications like preterm delivery, pre-eclampsia, and low birth weight were higher in anti-TPO antibody-positive patients as compared to anti-TPO antibody-negative patients. However, these findings were not statistically significant.
抗甲状腺抗体不仅会导致甲状腺功能障碍，还会在孕期及产后对胎儿和母亲产生独立的不良后果。慢性淋巴细胞性甲状腺炎作为免疫系统失调的一种表现，可能与胎儿 - 母体单位（胎盘）的免疫系统全面激活有关。这种干扰可能与母亲和胎儿的妊娠并发症相关。本研究旨在查明在恰尔肯德邦一家三级医疗机构中自身免疫性甲状腺疾病的发生率及其对母婴结局的影响。
这是一项前瞻性观察研究，在18个月期间对254名单胎妊娠且处于孕中期的孕妇进行，这些孕妇前往兰契RIMS医院的产前诊所（ANC）就诊。
254名孕妇中，222名（87.4%）的抗甲状腺过氧化物酶（anti - TPO）抗体低于35 IU/ml。32名患者（12.6%）的抗甲状腺过氧化物酶（anti - TPO）抗体呈阳性，其值大于35 IU/ml。抗TPO抗体平均值为22.54 ± 19.67 IU/ml。在222名抗TPO抗体检测呈阴性的个体中，7名（3.3%）发生流产，182名（88.3%）经阴道分娩，33名（14.9%）接受剖宫产。在32名抗TPO抗体检测呈阳性的个体中，2名（6.3%）发生流产，24名（75.0%）经阴道分娩，6名（18.8%）接受剖宫产。使用卡方检验，计算得出的值为0.549，表明无统计学意义（Pearson卡方检验值 = 0.200）。
抗TPO抗体阳性与流产和贫血显著相关。与抗TPO抗体阴性患者相比，抗TPO抗体阳性患者的其他并发症如早产、先兆子痫和低出生体重更高。然而，这些发现无统计学意义。
