scholarly journals Thyroid Peroxidase Antibodies as a Marker of Iodine Status in Healthy Euthyroid Women in First Trimester of Pregnancy Visiting a Tertiary Care Hospital in Raipur, India

2021 ◽  
Vol 10 (25) ◽  
pp. 1857-1861
Author(s):  
Rachita Nanda ◽  
Suprava Patel ◽  
Prasant Kumar Nayak ◽  
Eli Mohapatra ◽  
Sarita Agrawal

BACKGROUND The importance of adequate iodine status in pregnancy is undoubted as its deficiency is associated with adverse pregnancy outcomes for the mother as well as the foetus and neonate. Although median urine iodine concentration can assess iodine status of the population but not at an individual level. The purpose of this study was to assess the nutritional status of iodine and identify its effects on thyroid function during the first trimester of pregnancy. METHODS The study was carried out on 341 euthyroid healthy pregnant women using urine iodine concentration and other parameters of thyroid panel at a tertiary care hospital. RESULTS Median (interquartile range) urine iodine concentration and thyroid stimulating hormone (TSH) were 227.37 (161.7, 343.86) μg / L and 1.8 (1.1, 2.7) mIU / L respectively and Mean ± SD of free thyroxine and thyroid peroxidase antibodies were 14.53 ± 2.02 pmol / L and 38.23 ± 9.29 kIU / L respectively. Only thyroid peroxidase antibodies showed significant difference across groups with different iodine status. A positive correlation of urine iodine concentration (UIC) with thyroid peroxidase antibodies was observed (r = 0.137, P = 0.011). Multiple regression analysis revealed that thyroid peroxidase antibodies can serve as an independent predictor of iodine status in the presence of normal levels of TSH and FT4 (t - 3.063, CI; 0.880, 4.038, P = 0.002). CONCLUSIONS Thyroid peroxidase antibodies progressed positively with increase in urine iodine concentration indicating its role as a marker of iodine nutritional status and for early identification of women who can develop autoimmune thyroiditis resulting in hypothyroidism even prior to elevation of thyroid stimulating hormone levels. KEY WORDS Anti-TPO Ab, Free Thyroxine, Thyroid Stimulating Hormone, Urine Iodine Concentration

2019 ◽  
Vol 32 (1) ◽  
pp. 189-196 ◽  
Author(s):  
Dagnachew Muluye Fetene ◽  
Kim S. Betts ◽  
Rosa Alati

AbstractMaternal thyroid dysfunction during pregnancy may contribute to offspring neurobehavioral disorders. In this paper, we investigate the relationship between maternal thyroid function during pregnancy and offspring depression and anxiety. Data were taken from the Avon Longitudinal Study of Parents and Children. A total of 2,920 mother-child pairs were included. Thyroid-stimulating hormone levels, free thyroxine (FT4), and thyroid peroxidase antibodies were assessed during the first trimester of pregnancy because maternal supply is the only source of thyroid hormone for the fetus during the first 12 weeks of gestation. Child symptoms of depression and anxiety were assessed using the Development and Well-Being Assessment at ages 7.5 and 15 years. The odds of presenting with depression and anxiety were estimated using the generalized estimating equation. The level of FT4 during the first trimester of pregnancy was associated with child depression combined at ages 7.5 and 15 (odds ratio = 1.21, 95% confidence interval [1.00, 1.14]. An increase of 1 standard deviation of FT4 during pregnancy increased the odds of child depression by 28% after adjustment made for potential confounders. No association was found among maternal levels of thyroid-stimulating hormone, FT4, and thyroid peroxidase antibodies and childhood anxiety. In conclusion, increased levels of FT4 during the first trimester of pregnancy appear be linked to greater risk of offspring depression.


2009 ◽  
Vol 2 (4) ◽  
pp. 154-156
Author(s):  
Richard H Lee ◽  
Carole A Spencer ◽  
Martin N Montoro ◽  
Paola Aghajanian ◽  
T Murphy Goodwin ◽  
...  

The aim of the paper is to determine the prevalence of thyroid peroxidase antibodies (TPOAb) and assess its effect on the thyroid-stimulating hormone (TSH) reference range during pregnancy in a primarily Latina population. Serum samples were collected from healthy pregnant women and non-pregnant controls. TSH reference ranges were calculated when TPOAb-positive patients were either included or excluded. A total of 134 pregnant women and 107 non-pregnant controls were recruited. Positive TPOAb titres were found in 23 (17.2%) of the 134 pregnant women, and in 14 (13.1%) of the 107 non-pregnant controls. When the TPOAb-positive women were included in the TSH analysis, the upper reference limit using two different methods was consistently higher: 0–2.2 fold in the non-pregnant women, 2.01–2.78 fold in the first trimester, 3.18–4.7 fold in the second and 1.05–1.42 fold in the third. The lower TSH reference limit was not affected by the inclusion of TPOAb-positive subjects. In conclusion, inclusion of TPOAb-positive patients results in higher upper reference limits during pregnancy.


2019 ◽  
Vol 8 (9) ◽  
pp. 1288-1293 ◽  
Author(s):  
Jiashu Li ◽  
Aihua Liu ◽  
Haixia Liu ◽  
Chenyan Li ◽  
Weiwei Wang ◽  
...  

Thyroid dysfunction is a frequently found endocrine disorder among reproductively aged women. Subclinical hypothyroidism is the most common condition of thyroid disorders during pregnancy and is defined as manifesting a thyroid-stimulating hormone concentration exceeding the trimester-specific reference value, with a normal free thyroxine concentration. Here, we evaluated the prospective association between spontaneous miscarriage and first-trimester thyroid function. We conducted a case–control study (421 cases and 1684 controls) that was nested. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) status were measured. We found that higher TSH was related to spontaneous miscarriage (OR 1.21; 95% CI, 1.13–1.30, P < 0.001). Compared with women with TSH levels of 0.4–<2.5 mIU/L, the risk of miscarriage was increased in women with TSH levels of 2.5–<4.87 mIU/L (OR 1.47; 95% CI, 1.16–1.87) and TSH greater than 4.87 mIU/L (OR 1.97; 95% CI, 1.22–3.18). After controlling for the confounding factor, TPOAb positivity status and FT4, the results were similar. The present study showed that higher TSH was associated with miscarriage in early pregnancy. In fact, TSH levels between 2.5 and 4.87 mIU/L increased the risk for miscarriage, with TSH greater than 4.87 mIU/L increasing the risk even further.


2018 ◽  
Vol 31 (9) ◽  
pp. 995-1000
Author(s):  
Maja Vučinić ◽  
Vesna Kušec ◽  
Sandra Dundović ◽  
Jasenka Ille ◽  
Miroslav Dumić

Abstract Background High goiter prevalence caused by iodine deficiency (medium content 5.6 mg potassium iodide [KI]/kg of salt, median urine iodine concentration [UIC] 68 μg/L) in Croatia was observed in 1991 and 1995 when salt was iodized with 10 mg KI/kg. A new regulation introduced in 1996, specified 25 mg KI/kg of salt resulting in an increase of median UIC to 248 μg/L. Afterwards, goiter prevalence was only assessed in two small studies. Methods In this study, we investigated the prevalence and etiology of goiter in 3594 schoolchildren 17 years after an increase in salt iodization in Croatia. Thyroid size was determined by palpation in 1777 girls and 1817 boys aged 10–18 years. In goitrous children, a thyroid ultrasound and thyroid-stimulating hormone, free thyroxine (fT4), free triiodothyronine (fT3), thyroid peroxidase (TPO) and thyroglobulin (TG) antibody measurements were performed. Results Goiter was found in 32 children (0.89% vs. 2.8% in 1991, p<0.00001 and 27% in 1995, p<0.00001), simple goiter (SG) in 18/32 (56%) goitrous children vs. 126/152 (82.8%) in 1991 p<0.00001, autoimmune thyroiditis (AT) in 13/32 (40.6%) vs. 19/152 (12.5%) in 1991 p<0.0009, nodules in four: two cysts, toxic adenoma and carcinoma (in 1991 two adenomas and one cyst), Graves’ disease was not found (four in 1991). Subclinical hypothyroidism was found in three children. Thyroid disease was diagnosed in four of 32 children before the investigation. Increased iodine supply decreased goiter prevalence and SG/AT ratio in goitrous patients. Conclusions As thyroid abnormalities were found in 0.89% of children and some required treatment, thyroid examination is important in apparently healthy children regardless of sufficient iodization.


2019 ◽  
Vol 12 (3) ◽  
pp. 131-135
Author(s):  
Adam Grice

Subclinical hypothyroidism is a common condition associated with a raised thyroid-stimulating hormone and a normal serum free thyroxine that affects about 10% of females over 55 years in age. The most common cause is autoimmune thyroid disease, with 2.5% of patients with subclinical hypothyroidism progressing to clinically overt hypothyroidism each year. The rate of progression is higher in patients with anti-thyroid peroxidase antibodies and higher levels of thyroid-stimulating hormone. Only a small proportion of patients with subclinical hypothyroidism have symptoms, and although there is some debate in the literature about which patients should be treated, the National Institute for Health and Care Excellence clinical knowledge summaries give clear recommendations. There is an increased risk of cardiovascular disease in patients with subclinical hypothyroidism; it is uncertain whether treatment with levothyroxine reduces this risk. When deciding whether to treat subclinical hypothyroidism consider the patient’s age, symptoms, presence of anti-thyroid peroxidase antibodies, thyroid-stimulating hormone levels and risk factors such as cardiovascular disease.


2018 ◽  
Vol 5 (4) ◽  
pp. 1537 ◽  
Author(s):  
Manasi D. Garg ◽  
Poornima Kumar ◽  
Sakthi Abirami ◽  
Manikandan M. ◽  
Lalitha Krishnan

Background: Newborn screening using cord blood Thyroid Stimulating Hormone (TSH) is an effective and an easy way to screen babies for congenital hypothyroidism. Congenital hypothyroidism is a common preventable and treatable cause of mental retardation. Early diagnosis with the help of newborn screening aids in timely management and decreased morbidity. Various maternal and neonatal variables can affect cord blood TSH level thereby affecting the accurate diagnosis of congenital hypothyroidism. This study aims at studying the perinatal variables affecting cord blood TSH.Methods: In a retrospective cross-sectional study conducted in a tertiary care hospital, the hospital case records of 1465 newborn and their mother were studied for variables including cord blood TSH, maternal age, mode of delivery, parity, gender of baby, gestational age and growth of baby. The effect of these perinatal variables on cord blood TSH was analysed statistically. P value below 0.05 was considered as statistically significant. The statistical analysis was done used the SPSS software version 18.0.Results: The median cord blood TSH was 8 microIU/ml (IQR= 6-12) with 8.1% newborns having values more than 20 microIU/ml. Cord blood TSH was significantly raised in male babies (p <0.01) and in neonates born by assisted vaginal delivery (p <0.01).  Significant increase in cord blood TSH (p <0.02) was observed in neonates born to primiparous mothers. Maternal age, gestational age of the newborn and growth of the newborn did not have significant effect on cord blood TSH values.Conclusions: The mode of delivery, parity and gender of the baby were found to be significant variables affecting cord blood TSH values. Hence, cord blood TSH values should be interpreted in the light of these perinatal variables.


2010 ◽  
Vol 21 (6) ◽  
pp. 555-559 ◽  
Author(s):  
Annemieke Roos ◽  
Thera P. Links ◽  
Lolkje T.W. de Jong-van den Berg ◽  
Rijk O.B. Gans ◽  
Bruce H.R. Wolffenbuttel ◽  
...  

2013 ◽  
Vol 12 (2) ◽  
pp. 164-171
Author(s):  
Nishat Un Nahar ◽  
Zeba Un Naher ◽  
Md. Ashanul Habib ◽  
Forhadul Hoque Mollah

Introduction: Maternal thyroid dysfunction during pregnancy has been associated with a number of adverse outcomes, like preterm birth, placental abruption, foetal death and impaired neurological development in the child. Simultaneously the presence of antibody to thyroid peroxidase results miscarriage, preterm birth and maternal post partum thyroid disease. Post partum thyroiditis is closely associated with the presence of antibodies to thyroid peroxidase (TPO). Indeed if a pregnant woman is positive for TPO antibodies early in pregnancy, her chances of developing post partum thyroiditis is 30-52%. Objective: To find out the level of TPO-Ab and thyroid status in first trimester of pregnancy. Method: The cross sectional study was designed in Department of Biochemistry, BSMMU, Dhaka. Following inclusion and exclusion criteria 200 sample was selected by purposive and convenient sampling. The study parameters were- thyroid peroxidase antibody (TPO-Ab); serum thyroid stimulating hormone (TSH); serum free thyroxin (FT4). Results: 43 (21.5%) pregnant women of first trimester was found to be TPO-Ab positive, among these 43 subjects 16 (8.0%) had raised TSH i.e. >2.5 mIU/L and 27 had TSH level <2.5 mIU/L. Low serum FT4 was in 9 (4.5%) subjects. The study revealed that, there was a significant positive correlation between positive TPO-Ab (>12 IU/mL) and serum TSH level of study subjects and there was negative correlation between serum TSH (>2.5 mIU/L) and serum FT4 in study subjects. Conclusion: TPO-Ab positivity in first trimester of pregnancy and TPOAb positivity was associated with higher TSH and low FT4 level. Bangladesh Journal of Medical Science Vol. 12 No. 02 April’13 Page 164-170 DOI: http://dx.doi.org/10.3329/bjms.v12i2.14945


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