More follow-up needed in pregnant women with thyroid peroxidase antibodies

Issue: June 2011

13th European Congress of Endocrinology

More than one-third of women who test positive for thyroid peroxidase antibodies during pregnancy will develop abnormal thyroid hormone levels within 2 years of giving birth, prompting researchers to call for more follow-up in this population.

“This is rather surprising, as these positively screened women should have been referred to an endocrinologist already in pregnancy,” Eliska Potlukova, PhD, of Charles University in Prague, said in a press release. “Thus, in the general population, this number could be much higher. That means a lot of women — perhaps tens of thousands in one of the larger European countries — will have thyroid problems, which could be detected earlier.”

Potlukova and colleagues conducted a retrospective study to evaluate thyroid function in women with thyroid peroxidase antibodies (anti-TPO) who were euthyroid in pregnancy during a longer follow-up period. They assessed measurement of thyroid-stimulating hormone, free thyroxine, anti-TPO, and family and personal history in patients who tested positive for thyroid disorders during their first trimesters. Follow-up occurred at a median of 22 months after delivery.

Of the 189 women included in the study, 100 were positive for anti-TPO and originally had normal thyroid hormone levels during pregnancy. At follow-up, 13% of these women had TSH levels that were less than 0.37 mU/L; 15% had TSH levels between 4 mU/L and 10 mU/L; and 8% had TSH levels that were more than 10 mU/L, according to the researchers, and 35% of those who had never been treated developed thyroid dysfunction. Twenty-nine percent of those currently treated for thyroid dysfunction, however, had TSH levels outside of the normal range at follow-up.

Results also showed that only 49% of women had a family history of thyroid disorder and that serum levels of anti-TPO during pregnancy were not associated with the development of thyroid dysfunction.

“We need to be following up these women to try to catch their thyroid disease early, as this could have major implications for the health of the mother, baby and any subsequent babies who may be carried while the mother has a thyroid condition,” Potlukova said. “In addition, we need to educate women to be aware that having this antibody can have serious health implications for themselves and their families.”

For more information:

Potlukova E. Poster 436. Presented at: 13th European Congress of Endocrinology; April 30-May 4, 2011; Rotterdam, the Netherlands.

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