Non-endocrine autoimmune disorder doubles odds for multiple miscarriages for women with Hashimoto’s thyroiditis
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Women with Hashimoto’s thyroiditis plus a non-endocrine autoimmune disorder were more likely to have multiple miscarriages than those with Hashimoto’s thyroiditis, according to findings published in Thyroid.
“We have observed that in women with Hashimoto’s thyroiditis, the concurrent presence of further non-endocrine autoimmune disorders is characterized by a higher risk of recurrent pregnancy loss,” Marco Centanni, MD, professor in the department of medico-surgical sciences and biotechnologies at Sapienza University of Rome, and colleagues wrote. “The occurrence of an unexplained miscarriage in women with autoimmune thyroiditis should drive the search for additional autoimmune disorders.”
Centanni and colleagues compared data from women with Hashimoto’s thyroiditis and recurrent pregnancy loss: 65 had Hashimoto’s thyroiditis alone (median age, 28 years at initial miscarriage) and 22 had Hashimoto’s plus at least one other non-endocrine autoimmune disorder (median age, 31 years at initial miscarriage). Previous pregnancy outcomes were self-reported. The researchers used biopsies to determine non-endocrine autoimmune disorders and assessed antithyroid peroxidase antibodies as well as the presence of hypothyroidism and/or “a characteristic ultrasonographic pattern” to identify Hashimoto’s thyroiditis.
The researchers found that 5.64% of women with Hashimoto’s thyroiditis plus another non-endocrine autoimmune disorder and 2.1% of women with Hashimoto’s alone experienced recurrent pregnancy loss (P < .0001). In fact, there was a more than doubling of the likelihood of recurrent pregnancy loss among women with Hashimoto’s plus a non-endocrine autoimmune disorder vs. those with Hashimoto’s alone (OR = 2.78; 95% CI, 1.7-4.57).
Additionally, the researchers found that the likelihood of recurrent pregnancy loss was tripled for those with Hashimoto’s thyroiditis plus a non-endocrine autoimmune disorder vs. those with Hashimoto’s thyroiditis alone when assessing only women who were euthyroid. No difference was found between the groups in women with hypothyroidism.
“We observed that hypothyroidism represents a paramount factor in determining recurrent pregnancy loss,” the researchers wrote. “In fact, on subdivision of the whole sample based on thyroid function, the different rate of recurrent pregnancy loss between Hashimoto’s thyroiditis patients and those with Hashimoto’s thyroiditis plus a non-endocrine autoimmune disorder is still evident in euthyroid women but disappears in hypothyroid patients.”
When looking at specific types of non-endocrine autoimmune disorders, the researchers found that three of the 22 women had antiphospholipid syndrome.
“Our data suggest that this syndrome may only partially explain the abortive events recognized in polyautoimmune patients,” the researchers wrote. “Most of the miscarriages were linked to apparently unrelated autoimmune disorders, such as atrophic gastritis, connective tissue diseases and celiac disease.” – by Phil Neuffer
Disclosure: Healio could not confirm relevant financial disclosures at the time of publication.
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