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.

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

Low urinary iodine postpartum is associated with hypothyroid postpartum thyroid dysfunction and predicts long-term hypothyroidism

2011 ◽  
Vol 74 (5) ◽  
pp. 631-635 ◽  
Author(s):  
B. G. A. Stuckey ◽  
G. N. Kent ◽  
J. R. Allen ◽  
L. C. Ward ◽  
S. J. Brown ◽  
...  
Keyword(s):  
Thyroid Dysfunction ◽  
Urinary Iodine ◽  
Postpartum Thyroid Dysfunction

THE SPECTRUM OF POSTPARTUM THYROID DYSFUNCTION: DIAGNOSIS, MANAGEMENT, AND LONG-TERM PROGNOSIS

1996 ◽  
Vol 2 (6) ◽  
pp. 406-410 ◽  
Author(s):  
Nobuyuki Amino, MD ◽  
Hisato Tada, MD ◽  
Yoh Hidaka, MD
Keyword(s):  
Thyroid Dysfunction ◽  
Long Term Prognosis ◽  
Postpartum Thyroid Dysfunction

Efficacy of the Children's Oncology Group (COG) long-term follow-up (LTFU) guidelines in reducing risk of congestive heart failure (CHF) in childhood cancer survivors (CCS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9505-9505 ◽  
Author(s):  
F. Lennie Wong ◽  
Smita Bhatia ◽  
Seira Kurian ◽  
Wendy Landier ◽  
Liton Francisco ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Age At Onset ◽  
Cost Effective ◽  
Childhood Cancer Survivors ◽  
Left Ventricular ◽  
Life Years ◽  
Screening Strategies ◽  
Long Term Follow Up ◽  
Childhood Cancer Survivor Study

9505 Background: CCS are at risk for left ventricular dysfunction (LVD) and subsequent CHF due to exposure to anthracyclines and chest radiation (RT). COG LTFU guidelines recommend screening for LVD using echocardiograms (ECHOs) every 1-5y depending on anthracycline dose, RT, and age at cancer diagnosis. The relevance and cost-effectiveness of these consensus-based guidelines are unknown. Methods: Life expectancy and age at onset of CHF were projected in a simulated cohort (>1 million) of CCS undergoing screening ECHO per COG guidelines. Intervention for LVD was modeled to reduce annual CHF risk by 30%. Quality-adjusted life-years (QALYs) and lifetime costs with and without ECHO screening were calculated. Non-CHF mortality was estimated from the Childhood Cancer Survivor Study and US population rates. Costs and QOL adjustments were obtained from the Healthcare Cost and Utilization Project and medical literature. Screening was considered cost-effective if it resulted in a >6 month delay in onset of CHF and <$50,000/QALY gained. Results: Recommended screening strategies (Table) were cost-effective in: i) CCS exposed to ≥300mg/m² of anthracycline regardless of RT or age; and ii) CCS diagnosed at age 1-4y, exposed to RT and <300mg/m² of anthracycline. Screening was most cost-effective for CCS diagnosed at age 1-4y exposed to RT + ≥300 mg/m² of anthracycline (1.4y delay in CHF onset; $15,821/QALY gained). Screening as currently proposed was not cost-effective for other age/anthracycline/RT combinations. Conclusions: Recommended ECHO screening strategies are cost-effective for all CCS exposed to ≥300 mg/m² of anthracycline; screening was also cost-effective for those 1-4y at diagnosis, exposed to anthracycline <300 mg/m² + RT. Alternate screening strategies are needed for CCS with other exposure conditions. [Table: see text]

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 The Presence of Thyroid Peroxidase Antibody Is Associated with Lower Placental Weight in Maternal Thyroid Dysfunction

2019 ◽  
Vol 249 (3) ◽  
pp. 231-236 ◽  
Author(s):  
Junko Ushijima ◽  
Seishi Furukawa ◽  
Hiroshi Sameshima
Keyword(s):  
Thyroid Dysfunction ◽  
Placental Weight ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Maternal Thyroid
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