Screening for Postpartum Thyroid Dysfunction in the General Population Is Beneficial

Rationale—Microsomal antibodies have been related to postpartum thyroid dysfunction and postpartum depression. Objectives—To detect the value of microsomal antibodies during gestation in a random population, as a risk factor for thyroid dysfunction and depression during the postpartum period. Main findings—The presence of microsomal antibodies was investigated in a random population of 293 women at 32 weeks' gestation. At the same time, postpartum thyroid function was assessed repeatedly in all women every six weeks up to 34 weeks' postpartum. Postpartum thyroid dysfunction, defined as the presence of abnormal TSH, in combination with abnormal fT4 and/or fT3 values, occurred in 21 women (7.2%) during the postpartum period. Depression was assessed using the Research Diagnostic Criteria without knowing the results of biochemical thyroid function tests. At 32 weeks' gestation there were 27 (9.2%) women with elevated microsomal antibody titres. Compared with microsomalantibody negative women at 32 weeks' gestation, these women had an RR of 20 for developing postpartum thyroid dysfunction and an RR of 1.7 for developing postpartum depression. Conclusions—Women with elevated microsomal antibody titres during gestation are particularly at risk for postpartum thyroid dysfunction, but only have a slightly increased risk for postpartum depression.

Download Full-text

A prospective study of lymphocyte-initiated immunosuppression in normal pregnancy: evidence of a T-cell etiology for postpartum thyroid dysfunction

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.74.3.645 ◽

1992 ◽

Vol 74 (3) ◽

pp. 645-653 ◽

Cited By ~ 64

Author(s):

A. Stagnaro-Green

Keyword(s):

T Cell ◽

Prospective Study ◽

Thyroid Dysfunction ◽

Normal Pregnancy ◽

A Prospective Study ◽

Postpartum Thyroid Dysfunction

Download Full-text

Thyroid Peroxidase Antibody and Screening for Postpartum Thyroid Dysfunction

Journal of Thyroid Research ◽

10.4061/2011/745135 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 2

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.

Download Full-text

Selenium supplementation during and after pregnancy reduces the incidence of postpartum thyroid dysfunction

Inpharma Weekly ◽

10.2165/00128413-200715940-00039 ◽

2007 ◽

Vol &NA; (1594) ◽

pp. 17

Author(s):

&NA;

Keyword(s):

Thyroid Dysfunction ◽

Selenium Supplementation ◽

Postpartum Thyroid Dysfunction

Download Full-text

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

Folia Medica ◽

10.1515/folmed-2017-0027 ◽

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.

Download Full-text