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Assessment of serum thyroid hormone autoantibodies in the first trimester of gestation as predictors of postpartum thyroiditis.
J Clin Transl Endocrinol 2019; 18:100201JC

Abstract

Background

Measurement of serum thyroperoxidase autoantibodies (TPOAb) during gestation as a classical marker for the risk of postpartum thyroiditis (PPT) predicts PPT in 1/3 to 1/2 of women. Very few studies have measured serum thyroid hormone Ab (THAb) during gestation, and none as a possible marker for PPT.

Methods

In 412 women who were followed up from 7 to 11 weeks of gestation through 12 months after delivery, we measured THAb (T3.IgM, T3.IgG, T4.IgM, T4.IgG), thyroglobulin autoantibodies (TgAb) and TPOAb at study entry (7-11 week of gestation).

Results

Sixty-three women (15.3%) developed PPT, which progressed to permanent hypothyroidism (PH) in 34/63 (54%). THAb+ve were 21/412 women (5.1%), the frequency being greater in those who then developed PPT (12/63 [19.0%] vs. 9/349 [2.6%], P = 4.6 × 10-8), and in the PH subgroup (26.5% [9/34] vs. 10.3% [10/29], P = 0.12). THAb positivity occurred in 9/76 women (11.8%) who were TgAb and/or TPOAb+ve compared to 12/336 women who were TgAb and TPOAb negative (3.6%, P = 0.0031). Of these 9 THAb+ve, TgAb and/or TPOAb+ve women, all (100%) developed PPT compared to 3/11 (27.3%, P = 0.0011) THAb+ve, TgAb and/or TPOAb negative women. Of these 9 and 3 PPT women, 8 and 1 progressed to PH (88.9% and 33.3%, respectively, P = 0.12).

Conclusions

Gestational positivity of THAb enhance enormously the predictivity for PPT of gestational positivity of TPOAb/TgAb. However, their low frequency (5.1%) and their sensitivity (17.5% [21/63]) go against their application in lieu of TPOAb/TgAb.

Authors+Show Affiliations

Department of Clinical and Experimental Medicine, University of Messina, Italy. Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Italy. Interdepartmental Program on Molecular & Clinical Endocrinology, and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, 98125 Messina, Italy.Department of Clinical and Experimental Medicine, University of Messina, Italy.Department of Clinical and Experimental Medicine, University of Messina, Italy.Division of Obstetrics and Gynecology, University Hospital G. Martino, 98125 Messina, Italy.Division of Obstetrics and Gynecology, University Hospital G. Martino, 98125 Messina, Italy.Service of Immunometry and Laboratory Diagnosis, University Hospital G. Martino, 98125 Messina, Italy.Service of Immunometry and Laboratory Diagnosis, University Hospital G. Martino, 98125 Messina, Italy.Department of Clinical and Experimental Medicine, University of Messina, Italy.Department of Clinical and Experimental Medicine, University of Messina, Italy.Division of Obstetrics and Gynecology, University Hospital G. Martino, 98125 Messina, Italy. Department of Human Pathology Gaetano Barresi, University of Messina, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31428563

Citation

Benvenga, Salvatore, et al. "Assessment of Serum Thyroid Hormone Autoantibodies in the First Trimester of Gestation as Predictors of Postpartum Thyroiditis." Journal of Clinical & Translational Endocrinology, vol. 18, 2019, p. 100201.
Benvenga S, Vita R, Di Bari F, et al. Assessment of serum thyroid hormone autoantibodies in the first trimester of gestation as predictors of postpartum thyroiditis. J Clin Transl Endocrinol. 2019;18:100201.
Benvenga, S., Vita, R., Di Bari, F., Lo Re, C., Scilipoti, A., Giorgianni, G., ... Le Donne, M. (2019). Assessment of serum thyroid hormone autoantibodies in the first trimester of gestation as predictors of postpartum thyroiditis. Journal of Clinical & Translational Endocrinology, 18, p. 100201. doi:10.1016/j.jcte.2019.100201.
Benvenga S, et al. Assessment of Serum Thyroid Hormone Autoantibodies in the First Trimester of Gestation as Predictors of Postpartum Thyroiditis. J Clin Transl Endocrinol. 2019;18:100201. PubMed PMID: 31428563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of serum thyroid hormone autoantibodies in the first trimester of gestation as predictors of postpartum thyroiditis. AU - Benvenga,Salvatore, AU - Vita,Roberto, AU - Di Bari,Flavia, AU - Lo Re,Carmela, AU - Scilipoti,Angela, AU - Giorgianni,Grazia, AU - Grasso,Loredana, AU - Galletti,Marina Raffaella, AU - Mandolfino,Mattia Grazia, AU - Le Donne,Maria, Y1 - 2019/07/24/ PY - 2019/06/21/received PY - 2019/07/22/revised PY - 2019/07/22/accepted PY - 2019/8/21/entrez PY - 2019/8/21/pubmed PY - 2019/8/21/medline KW - DM-1, type 1 diabetes mellitus KW - FNAB, fine-needle aspiration biopsy KW - FT3, free triiodothyronine KW - FT4, free thyroxine KW - GD, Graves’ disease KW - HT, Hashimoto’s thyroiditis KW - L-T4, Levothyroxine KW - PH, permanent hypothyroidism KW - PPT, Postpartum thyroiditis KW - Postpartum KW - Postpartum thyroiditis KW - Pregnancy KW - THAb, thyroid hormone autoantibodies KW - TPOAb, thyroperoxidase autoantibodies KW - TSH, thyrotropin KW - Tg, thyroglobulin KW - TgAb, thyroglobulin autoantibodies KW - Thyroid autoimmunity KW - Thyroid hormone autoantibodies KW - US, ultrasound KW - UST, ultrasonography signs suggestive of thyroiditis SP - 100201 EP - 100201 JF - Journal of clinical & translational endocrinology JO - J Clin Transl Endocrinol VL - 18 N2 - Background: Measurement of serum thyroperoxidase autoantibodies (TPOAb) during gestation as a classical marker for the risk of postpartum thyroiditis (PPT) predicts PPT in 1/3 to 1/2 of women. Very few studies have measured serum thyroid hormone Ab (THAb) during gestation, and none as a possible marker for PPT. Methods: In 412 women who were followed up from 7 to 11 weeks of gestation through 12 months after delivery, we measured THAb (T3.IgM, T3.IgG, T4.IgM, T4.IgG), thyroglobulin autoantibodies (TgAb) and TPOAb at study entry (7-11 week of gestation). Results: Sixty-three women (15.3%) developed PPT, which progressed to permanent hypothyroidism (PH) in 34/63 (54%). THAb+ve were 21/412 women (5.1%), the frequency being greater in those who then developed PPT (12/63 [19.0%] vs. 9/349 [2.6%], P = 4.6 × 10-8), and in the PH subgroup (26.5% [9/34] vs. 10.3% [10/29], P = 0.12). THAb positivity occurred in 9/76 women (11.8%) who were TgAb and/or TPOAb+ve compared to 12/336 women who were TgAb and TPOAb negative (3.6%, P = 0.0031). Of these 9 THAb+ve, TgAb and/or TPOAb+ve women, all (100%) developed PPT compared to 3/11 (27.3%, P = 0.0011) THAb+ve, TgAb and/or TPOAb negative women. Of these 9 and 3 PPT women, 8 and 1 progressed to PH (88.9% and 33.3%, respectively, P = 0.12). Conclusions: Gestational positivity of THAb enhance enormously the predictivity for PPT of gestational positivity of TPOAb/TgAb. However, their low frequency (5.1%) and their sensitivity (17.5% [21/63]) go against their application in lieu of TPOAb/TgAb. SN - 2214-6237 UR - https://www.unboundmedicine.com/medline/citation/31428563/Assessment_of_serum_thyroid_hormone_autoantibodies_in_the_first_trimester_of_gestation_as_predictors_of_postpartum_thyroiditis L2 - https://linkinghub.elsevier.com/retrieve/pii/S2214-6237(19)30069-9 DB - PRIME DP - Unbound Medicine ER -