Thyroid Peroxidase Antibodies in Early Pregnancy: Utility for Prediction of Postpartum Thyroid Dysfunction and Implications for Screening

Thyroid ◽  
2004 ◽  
Vol 14 (8) ◽  
pp. 610-615 ◽  
Author(s):  
L.D.K.E. Premawardhana ◽  
A.B. Parkes ◽  
R. John ◽  
B. Harris ◽  
J.H. Lazarus
Keyword(s):  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibodies ◽  
Postpartum Thyroid Dysfunction

scholarly journals Thyroid Peroxidase Antibody and Screening for Postpartum Thyroid Dysfunction

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mohamed A. Adlan ◽  
Lakdasa D. Premawardhana
Keyword(s):  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Screening Tool ◽  
Cost Effective ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Screening Strategies ◽  
Considerable Morbidity ◽  
Postpartum Thyroid Dysfunction

Postpartum thyroid dysfunction (PPTD) is a common disorder which causes considerable morbidity in affected women. The availability of effective treatment for hypothyroid PPTD, the occurrence of the disease in subsequent pregnancies and the need to identify subjects who develop long term hypothyroidism, has prompted discussion about screening for this disorder. There is currently no consensus about screening as investigations hitherto have been variable in their design, definitions and assay frequency and methodology. There is also a lack of consensus about a suitable screening tool although thyroid peroxidase antibody (TPOAb) is a leading contender. We present data about the use of TPOAb in early pregnancy and its value as a screening tool. Although its positive predictive value is moderate, its sensitivity and specificity when used in early pregnancy are comparable or better compared to other times during pregnancy and the postpartum period. Recent studies have also confirmed this strategy to be cost effective and to compare favourably with other screening strategies. We also explore the advantages of universal screening.

scholarly journals Postpartum Thyroid Dysfunction in Pregnant Thyroid Peroxidase Antibody-Positive Women Living in an Area with Mild to Moderate Iodine Deficiency: Is Iodine Supplementation Safe?

2000 ◽  
Vol 85 (9) ◽  
pp. 3191-3198 ◽  
Author(s):  
Susanne B. Nøhr ◽  
Annemette Jørgensen ◽  
Klaus M. Pedersen ◽  
Peter Laurberg
Keyword(s):  
Thyroid Hormones ◽  
Iodine Deficiency ◽  
Early Pregnancy ◽  
Postpartum Period ◽  
Thyroid Dysfunction ◽  
Thyroid Peroxidase ◽  
Iodine Supplementation ◽  
Thyroid Peroxidase Antibody ◽  
Significant Difference ◽  
Postpartum Thyroid Dysfunction

Abstract In moderately iodine-deficient, pregnant, thyroid peroxidase antibody (TPO-Ab)-positive women the role of iodine supplementation in the development of postpartum thyroid dysfunction (PPTD) was studied in a placebo-controlled, randomized, double blind trial. Screening for TPO-Ab was performed in early pregnancy in a population of healthy pregnant Danish women with no previous diagnosed thyroid disease (prevalence, 117 of 1284; 9.1%). The participants were randomized, stratified according to TPO-Ab level, to three groups. All participants received a daily vitamin and mineral tablet with 150 μg iodine or no iodine. The +/+ group received iodine during pregnancy and the postpartum period, the +/− group received iodine during pregnancy only, and the −/− group received no iodine supplementation. A total of 66 TPO-Ab positive women were followed, and in the postpartum period sera were collected at 8-week interval for biochemical evaluation of thyroid function and antibody level. Compliance was evaluated by 24-h urinary iodine measurements. PPTD developed in 55% of the participants. In 67% of the cases abnormal TSH was accompanied by abnormalities in thyroid hormones, whereas 33% had abnormal serum TSH only. There was no statistically significant difference in the frequency of PPTD in the three groups:+ /+ group, 59% (95% confidence interval, 36−79%); +/− group, 60% (36−81%); and −/− group, 46% (26–67%). There were also no differences in the severity of the PPTD, as evaluated by duration and grade of deviation of TSH and thyroid hormones from normality. The occurrence, severity, and type of PPTD predominantly depended on the TPO-Ab level: TPO-Ab below 200 U/L at screening, 35% developed PPTD; TPO-Ab of 200–900 U/L, 54%; and TPO-Ab above 900 U/L, 75% developed PPTD. Women with low levels of antibodies predominantly remained euthyroid or had hyperthyroidism only, whereas women with high antibody levels had hyperthyroidism followed by hypothyroidism or hypothyroidism only. We conclude that iodine supplementation (150 μg) during pregnancy and the postpartum period to TPO-Ab-positive women living in an area with mild to moderate iodine deficiency did not induce or worsen PPTD. The study confirmed that screening for TPO-Ab in early pregnancy can predict women at high risk for development of PPTD.

scholarly journals High Body Mass Index Is an Indicator of Maternal Hypothyroidism, Hypothyroxinemia, and Thyroid-Peroxidase Antibody Positivity during Early Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Cheng Han ◽  
Chenyan Li ◽  
Jinyuan Mao ◽  
Weiwei Wang ◽  
Xiaochen Xie ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Pregnant Women ◽  
Body Mass ◽  
Thyroid Function ◽  
Early Pregnancy ◽  
Thyroid Dysfunction ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Maternal Thyroid ◽  
High Bmi

Background. Maternal thyroid dysfunction in early pregnancy may increase the risk of adverse pregnancy complications and neurocognitive deficiencies in the developing fetus. Currently, some researchers demonstrated that body mass index (BMI) is associated with thyroid function in nonpregnant population. Hence, the American Thyroid Association recommended screening thyroid function in obese pregnant women; however, the evidence for this is weak. For this purpose, our study investigated the relationship between high BMI and thyroid functions during early pregnancy in Liaoning province, an iodine-sufficient region of China.Methods. Serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) concentration, urinary iodine concentration (UIC), and BMI were determined in 6303 pregnant women.Results. BMI ≥ 25 kg/m2may act as an indicator of hypothyroxinemia and TPOAb positivity and BMI ≥ 30 kg/m2was associated with increases in the odds of hypothyroidism, hypothyroxinemia, and TPOAb positivity. The prevalence of isolated hypothyroxinemia increased among pregnant women with BMI > 24 kg/m2.Conclusions. High BMI during early pregnancy may be an indicator of maternal thyroid dysfunction; for Asian women whose BMI > 24 kg/m2and who are within 8 weeks of pregnancy, thyroid functions should be assessed especially.

scholarly journals Risk Factors for Postpartum Thyroid Dysfunction in Euthyroid Women Prior to Pregnancy

Folia Medica ◽  
2017 ◽  
Vol 59 (2) ◽  
pp. 190-196
Author(s):  
Boyan I. Nonchev ◽  
Antoaneta V. Argatska ◽  
Blagovest K. Pehlivanov ◽  
Maria M. Orbetzova
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Early Pregnancy ◽  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Multivariate Logistic Regression Analysis ◽  
Postpartum Women ◽  
Increased Risk ◽  
History Of ◽  
Postpartum Thyroid Dysfunction

AbstractBackground:Thyroid dysfunction is common during the postpartum and the predisposing factors for its development are considered specific for the population studied. The aim of this study was to evaluate the risk factors for the occurrence of postpartum thyroid dysfunction (PPTD) in euthyroid women prior to pregnancy.Materials and methods:Forty-five women with PPTD and 55 age-matched euthyroid postpartum women from Plovdiv, Bulgaria were included in the study. TSH, FT4, FT3, TPOAb, TgAb, TRAb were measured and ultrasound evaluation of the thyroid was performed in the first trimester of pregnancy and during the postpartum.Results:The study found higher risk of developing PPTD in women with family history of thyroid disease (OR 4.42; 95% CI 1.87,10.43), smokers (OR 4.01; 95% CI 1.72,9.35), personal history of autoimmune thyroid disease (OR 5.37; 95% CI 1.15,28.53), positive TPOAb (OR 18.12; 95% CI 4.93,66.65) and thyroid US hypoechogenicity during early pregnancy (OR 6.39; 95% CI 2.53,16.12) and those who needed levothyroxine during pregnancy (OR 3.69; 95% CI 1.28,10.61). BMI before pregnancy was significantly lower in women with PPTD than in euthyroid postpartum women (22.80±0.55 vs 26.25±0.97, p=0.013). The multivariate logistic regression analysis identified as most important independent risk factors for PPTD occurrence the TPOAb positivity during early pregnancy, family history of thyroid disease, smoking and lower BMI before pregnancy.Conclusion:Our data suggest that in the population studied several factors are associated with an increased risk of PPTD and screening for thyroid disorders among those women can be beneficial.

scholarly journals Prevalence of thyroid dysfunction and anti-thyroid peroxidase antibodies in vitiligo patients

2017 ◽  
Vol 3 (1) ◽  
pp. 140 ◽  
Author(s):  
Jishna P. ◽  
M. P. Binitha ◽  
Abdul Latheef E. N. ◽  
V. P. Anilakumari
Keyword(s):  
Autoimmune Diseases ◽  
Thyroid Dysfunction ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Cross Sectional ◽  
Autoimmune Thyroid ◽  
Thyroid Peroxidase Antibodies ◽  
Thyroid Peroxidase Antibody ◽  
Antibody Positivity ◽  
Antibody Levels

<p class="abstract"><strong>Background:</strong> Vitiligo is associated with various autoimmune diseases, including autoimmune thyroid disease. The objectives of the present study was to determine the prevalence of thyroid dysfunction and anti-thyroid peroxidase antibodies in patients with vitiligo, and to compare the clinical profile of anti-thyroid peroxidase positive and anti-thyroid peroxidase negative patients<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> A cross-sectional comparative study was conducted in 100 patients with vitiligo and 100 controls. After dermatologic and systemic evaluation, serum thyroid hormones and anti-thyroid peroxidase antibody levels were measured in all the subjects.<strong></strong></p><p class="abstract"><strong>Results:</strong> Thyroid dysfunction was more common in the vitiligo group (27%) than in the controls. Serum thyroid stimulating hormone abnormalities were more common in the vitiligo group (27%) than in the controls (6%). The most common thyroid dysfunction was subclinical hypothyroidism. Anti-thyroid peroxidase antibody positivity was higher in the vitiligo group (36%) when compared to the controls (24%), and the most common type of vitiligo was vitiligo vulgaris (18%) in this group. Thyroid dysfunction and anti-thyroid peroxidase positivity were more common in women (58%) when compared to men (42%). There was a significantly higher prevalence of other autoimmune diseases in the vitiligo group (20%) compared to the controls (6%)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study shows a significant association between vitiligo and thyroid dysfunction, anti-thyroid peroxidase antibodies and other autoimmune diseases. We recommend that thyroid evaluation and regular follow-up should be done in patients with vitiligo for prompt detection of thyroid dysfunction<span lang="EN-IN">.</span></p>

scholarly journals Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT)

2000 ◽  
Vol 143 (5) ◽  
pp. 639-647 ◽  
Author(s):  
T Bjoro ◽  
J Holmen ◽  
O Kruger ◽  
K Midthjell ◽  
K Hunstad ◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Thyroid Dysfunction ◽  
Thyroid Autoimmunity ◽  
Health Study ◽  
Thyroid Peroxidase ◽  
Blood Samples ◽  
Thyroid Peroxidase Antibodies ◽  
High Prevalence ◽  
History Of ◽  
Unselected Population

OBJECTIVE: To examine the prevalence of thyroid disease and dysfunction including thyroid autoimmunity in Norway. MATERIALS AND METHODS: All inhabitants 20 years and older (94009) in Nord-Trondelag were invited to participate in a health survey with a questionnaire and blood samples. RESULTS: The prevalence of former diagnosed hyperthyroidism was 2.5% in females and 0.6% in males, hypothyroidism 4.8% and 0.9%, and goitre 2.9% and 0.4% respectively. In both sexes the prevalence increased with age. In individuals without a history of thyroid disease the median, 2.5 and 97.5 percentiles for TSH (mU/l) were 1.80 and 0.49-5.70 for females and 1. 50 and 0.56-4.60 for males. The TSH values increased with age. When excluding individuals with positive thyroid peroxidase antibodies (TPOAb) (>200U/ml), the 97.5 percentiles dropped to 3.60 mU/l and 3. 40 mU/l respectively. The prevalence of pathological TSH values in females and males were TSH >/=10mU/l 0.90% and 0.37%; TSH 4.1-9. 9mU/l 5.1% and 3.7%; and TSH</=0.05mU/l 0.45% and 0.20% respectively. The prevalence of positive TPOAb (>200U/ml) was 13.9% in females and 2.8% in males. In females the lowest percentage (7.9%) of positive TPOAb was seen with TSH 0.2-1.9mU/l and increased both with lower and higher levels of TSH. The percentage of males with positive TPOAb was lower than in females in all TSH groups except for those with TSH>10mU/l (85% TPOAb positive). CONCLUSIONS: In spite of a high prevalence of recognised thyroid disease in the population a considerable number of inhabitants have undiagnosed thyroid dysfunction and also positive TPOAb.

scholarly journals Metabolic Syndrome, Thyroid Function and Autoimmunity - The PORMETS Study

2019 ◽  
Vol 19 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Luís Raposo ◽  
Sandra Martins ◽  
Daniela Ferreira ◽  
João Tiago Guimarães ◽  
Ana Cristina Santos
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Dysfunction ◽  
Positive Association ◽  
National Sample ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Cross Sectional ◽  
Thyroid Peroxidase Antibodies ◽  
The Metabolic Syndrome

Background:The prevalence of thyroid dysfunction and autoimmunity in the Portuguese population has not yet been estimated. However, the national prevalence of the metabolic syndrome remains high. The association of thyroid pathology with cardiovascular risk has been addressed but is still unclear. Our study aimed to evaluate the prevalence of thyroid dysfunction and autoimmunity and to assess the associations of thyroid-stimulating hormone and thyroid hormones and antibodies with metabolic syndrome, its components, and other possible determinants in a national sample.Material and Methods:The present study included a subsample of 486 randomly selected participants from a nationwide cross-sectional study sample of 4095 adults. A structured questionnaire was administered on past medical history and socio-demographic and behavioural characteristics. Blood pressure and anthropometric measurements were collected, and the serum lipid profile, glucose, insulin, hs- CRP, TSH, FT4, FT3 and thyroid antibodies were measured.Results:In our sample, the prevalence of hypothyroidism, hyperthyroidism and undiagnosed dysfunction was 4.9%, 2.5% and 72.2%, respectively. Overall, the prevalence of positivity for the thyroid peroxidase and thyroglobulin antibodies was 11.9% and 15.0%, respectively. A positive association was found between free triiodothyronine and metabolic syndrome (OR: 2.019; 95% CI: 1.196, 3.410). Additionally, thyroid peroxidase antibodies had a negative association with metabolic syndrome (OR: 0.465; 95% CI: 0.236, 0.917) and its triglyceride component (OR: 0.321; 95% CI: 0.124, 0.836).Conclusion:The prevalence of undiagnosed thyroid dysfunction and autoimmunity was high. Thyroid peroxidase antibodies were negatively associated with metabolic syndrome and its triglyceride component, whereas the free triiodothyronine level was positively associated with metabolic syndrome.

scholarly journals Incidence and Pattern of Thyroid Dysfunction in Patients on Chronic Amiodarone Therapy: Experience at a Tertiary Care Centre in Oman

2013 ◽  
Vol 7 (1) ◽  
pp. 122-126 ◽  
Author(s):  
H. Farhan ◽  
A. Albulushi ◽  
A. Taqi ◽  
A. Al-Hashim ◽  
K. Al-Saidi ◽  
...  
Keyword(s):  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Female Gender ◽  
University Hospital ◽  
Thyroid Peroxidase ◽  
Amiodarone Therapy ◽  
Tertiary Care Centre ◽  
Sultan Qaboos University ◽  
Thyroid Peroxidase Antibodies ◽  
Periodic Monitoring

Objective: To determine the incidence and pattern of thyroid dysfunction (TD) in patients on chronic amiodarone therapy. Methods: A retrospective study which evaluated 59 patients who had received amiodarone therapy regularly for at least 12 months from a period of 3 years from October 2007 to October 2010. The patients were followed-up at the cardiac clinic at Sultan Qaboos University Hospital, Muscat, Oman. Results: The mean age of the cohort was 63 ± 13 years ranging from 27 to 98 years. Fifty-one percent (n = 30) of the patients were female. There were 11 (19%) cases of thyroid dysfunction (TD). Seven (12%) patients were hypothyroid, 3 (5%) had hyperthyroidism and 1 (2%) patient had sub-clinical hypothyroidism; no cases of sub-clinical hyperthyroidism were noted. Female gender and presence of anti-thyroid peroxidase antibodies were significantly associated with amiodarone-induced hypothyroidism (p = 0.001) while age, amiodarone dose and duration of therapy were not correlated with the development of TD (all p-values > 0.05). Conclusion: Amiodarone-induced thyroid dysfunction is prevalent. Hypothyroidism was more frequent and seen more in female patients and those who had positive anti-thyroid peroxidase antibodies. Initial screening and periodic monitoring of thyroid function is mandatory for all patients on amiodarone therapy.

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