Value of combined clinical information and thyroid peroxidase antibodies in pregnancy for the prediction of postpartum thyroid dysfunction.

Abstract

PROBLEM:

To investigate the utility of thyroid peroxidase antibodies (TPOAb) in early pregnancy combined with clinical information for prediction of postpartum thyroid dysfunction (PPTD) within 1 year postpartum.

METHOD OF STUDY:

We studied 98 pregnant women by determining their TPOAb levels in early pregnancy, as well as their serum thyrotropin and free thyroid (fT4) levels at 6 and 12 months postpartum. Furthermore, they answered a questionnaire and physical examination was performed by only one examiner.

RESULTS:

Of the 98 women, 10 were positive TPOAb in early pregnancy. The overall risk of PPTD within 1 year of follow-up was 10.2% (95% CI 4.1-16.3). Risk of PPTD was significantly higher among women with a family history of thyroid disease, TPOAb positive and presenting goiter in early pregnancy. The sensitivity, specificity and positive predictive value of TPOAb in PPTD prediction were 60.0%, 95.5% and 60%. Restricting screening to women with a family history of thyroid disease or presenting goiter increases the positive predictive value from 60% to 82.4%.

CONCLUSION:

Our results suggest that TPOAb could be used as a screening test for PPTD prediction at least among women who present a high risk of developing PPTD.

• Authors: Sheila Mamede da Costa, Lino Sieiro Netto, Claudia Medina Coeli, Alexandru Buescu, Mario Vaisman
• Journal: American journal of reproductive immunology (New York, N.Y. : 1989) (Am J Reprod Immunol) Vol. 58 Issue 4 Pg. 344-9 (Oct 2007) ISSN: 1046-7408 [Print] Denmark
• PMID: 17845204 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Autoantibodies
• Autoantigens
• Iron-Binding Proteins
• Thyrotropin
• TPO protein, human
• Iodide Peroxidase
• Thyroxine

Topics

• Adolescent
• Adult
• Autoantibodies (blood)
• Autoantigens (immunology)
• Female
• Follow-Up Studies
• Humans
• Iodide Peroxidase (immunology)
• Iron-Binding Proteins (immunology)
• Mass Screening (methods)
• Postpartum Period (blood)
• Predictive Value of Tests
• Pregnancy
• Pregnancy Trimester, First (immunology)
• Risk Assessment
• Risk Factors
• Sensitivity and Specificity
• Surveys and Questionnaires
• Thyroid Diseases (blood, diagnosis, etiology, immunology)
• Thyrotropin (blood)
• Thyroxine (blood)
• Time Factors