Value of Combined Clinical Information and Thyroid Peroxidase Antibodies in Pregnancy for the Prediction of Postpartum Thyroid Dysfunction

2007 ◽  
Vol 58 (4) ◽  
pp. 344-349 ◽  
Author(s):  
Sheila Mamede da Costa ◽  
Lino Sieiro Netto ◽  
Claudia Medina Coeli ◽  
Alexandru Buescu ◽  
Mario Vaisman
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mohamed A. Adlan ◽  
Lakdasa D. Premawardhana

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.


Author(s):  
Jishna P. ◽  
M. P. Binitha ◽  
Abdul Latheef E. N. ◽  
V. P. Anilakumari

<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>


Author(s):  
Priya Maurya ◽  
Neeta Chaudhary ◽  
Natasha Tyagi ◽  
M. R. Kural ◽  
Kriti Bhatnagar

Background: Thyroid disorder is one of the most common disorder in pregnancy. Thyroid disorder is known to be associated with abnormal maternal and foetal outcomes and overlooked in pregnant women because of non-specific symptoms and hypermetabolic state of pregnancy of pregnancy. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effects on mother and the foetus like miscarriages, preterm delivery, pre-eclampsia, eclampsia, polyhydramnios, placental abruption, postpartum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorder on pregnancy and its maternal and foetal outcome.Methods: The present study was conducted in Muzaffarnagar Medical College, Uttar Pradesh, India in collaboration of department of Gynecology and Obstetrics and Pediatrics Department. It is a prospective random cross-sectional study done over 400 pregnant women which includes known cases of thyroid disorder. Serum thyroid stimulating hormone (TSH) test was apart from the routine blood sample investigations as per FOGSI-ICOG good clinical practice recommendation. fT3, fT4 and thyroid peroxidase antibody test were done in patients with a deranged TSH value. Patients were followed up till delivery, and their obstetrics and perinatal outcomes were noted and managed.Results: In present study out of 400 cases, 25 cases are hypothyroidism and 16 cases are hyperthyroidism in pregnancy. Out of these 41 patients with thyroid dysfunction, complications associated were abortions (14.63%), maternal anaemia (9.7%), pre-eclampsia (12.2%), preterm labour (9.76%), abruption placenta (4.88%), IUGR (2.4%), Still birth (7.32%). Out of 41 patients with thyroid dysfunction, foetal complications seen were hyperbilirubinemia (12.2%), Foetal distress (4.88%), NICU admission (17.07%) and low birth weight (21.95%).Conclusions: Thyroid disorder in pregnancy have adverse effects on maternal and foetal outcome emphasizing the importance of routine antenatal thyroid screening.


2000 ◽  
Vol 143 (5) ◽  
pp. 639-647 ◽  
Author(s):  
T Bjoro ◽  
J Holmen ◽  
O Kruger ◽  
K Midthjell ◽  
K Hunstad ◽  
...  

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.


2002 ◽  
pp. 443-451 ◽  
Author(s):  
PR Gallas ◽  
RP Stolk ◽  
K Bakker ◽  
E Endert ◽  
WM Wiersinga

BACKGROUND: The prevalence of thyroid dysfunction in pregnancy and in the first postpartum year (postpartum thyroid dysfunction (PPTD)) in women with diabetes mellitus type 1 (DM1) is known to be higher than in the general population. To assess prevalence, incidence and risk factors in The Netherlands we performed a prospective cohort study. DESIGN: From 1994 to 1998, 126 women with DM1 from eight Dutch clinics were included. TSH, free thyroxine, free tri-iodothyronine and anti-thyroid peroxidase antibodies (TPO-ab) were measured pre-pregnancy, in the first and last trimester of pregnancy and at 1.5, 3, 6, 9 and 12 months after delivery. RESULTS: Eighty-two women completed the study. Thyroid dysfunction during pregnancy was observed in 22.5% (first trimester) and 18.4% (third trimester), and mostly consisted of subclinical hypothyroidism. Baseline characteristics of women with thyroid dysfunction in pregnancy did not differ from those without thyroid dysfunction. Overt PPTD was seen in 15.9%. Incidence of PPTD was 10%. Patients with PPTD were slightly older than those without PPTD and the prevalence of TPO-ab was higher in these women. CONCLUSION: In women with DM1 the prevalence of thyroid dysfunction during pregnancy and overt PPTD is 3-fold higher than in the general Dutch population. Risk factors are age and TPO-ab. Given the possible impact on psychomotor development of the offspring and on well-being of the mother these data suggest there is a case for screening (pre-)pregnant women with DM1 for TSH and TPO-ab.


Author(s):  
Luís Raposo ◽  
Sandra Martins ◽  
Daniela Ferreira ◽  
João Tiago Guimarães ◽  
Ana Cristina Santos

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.


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