Esplin M S, Branch D W, Silver R, Stagnaro-Green A
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Am J Obstet Gynecol. 1998 Dec;179(6 Pt 1):1583-6. doi: 10.1016/s0002-9378(98)70029-8.
Approximately 1% of all women have recurrent pregnancy loss, defined as >/=3 spontaneous losses of pregnancy; however, a cause is determined in only 50% of cases. Recent studies have associated the presence of thyroid autoantibodies during the first trimester of pregnancy with spontaneous abortion in the current pregnancy among women without a history of recurrent abortion. The objective of this study was to determine whether circulating thyroid autoantibodies were associated with recurrent pregnancy loss.
Sera from 74 nonpregnant women with a history of recurrent pregnancy loss and from 75 healthy, fertile control subjects of similar gravidity were tested for thyroglobulin and thyroid peroxidase antibodies by means of radioimmunoassay kits. All women had a third-generation thyroid-stimulating hormone assay performed. Samples were obtained >/=6 months after a pregnancy.
Twenty-two of the women with a history of recurrent pregnancy loss (29.3%) and twenty-eight of the control subjects (37%) had positive results for either one or both of the thyroid autoantibodies (P >. 05). Mean thyroid-stimulating hormone levels and the proportion of women with abnormal thyroid-stimulating hormone values did not differ between the 2 groups.
Women with a history of recurrent pregnancy loss are no more likely than are fertile control subjects to have circulating thyroid autoantibodies. Testing for antithyroid antibodies is not clinically useful in the evaluation of patients with a history of recurrent pregnancy loss.
约1%的女性有复发性流产，定义为妊娠≥3次自然流产；然而，仅50%的病例能找到病因。最近的研究表明，在无复发性流产病史的女性中，妊娠早期甲状腺自身抗体的存在与当前妊娠的自然流产有关。本研究的目的是确定循环甲状腺自身抗体是否与复发性流产有关。
采用放射免疫分析试剂盒对74例有复发性流产病史的未孕女性和75例妊娠情况相似的健康可育对照者的血清进行甲状腺球蛋白和甲状腺过氧化物酶抗体检测。所有女性均进行了第三代促甲状腺激素检测。样本在妊娠≥6个月后采集。
有复发性流产病史的女性中有22例（29.3%），对照者中有28例（37%）一种或两种甲状腺自身抗体检测呈阳性（P＞0.05）。两组的平均促甲状腺激素水平以及促甲状腺激素值异常的女性比例无差异。
有复发性流产病史的女性与可育对照者相比，循环甲状腺自身抗体阳性的可能性并无增加。检测抗甲状腺抗体对评估有复发性流产病史的患者并无临床意义。
