Value of combined clinical information and thyroid peroxidase antibodies in pregnancy for the prediction of postpartum thyroid dysfunction

Am J Reprod Immunol. 2007 Oct;58(4):344-9. doi: 10.1111/j.1600-0897.2007.00508.x.

Abstract

Problem: To investigate the utility of thyroid peroxidase antibodies (TPOAb) in early pregnancy combined with clinical information for prediction of postpartum thyroid dysfunction (PPTD) within 1 year postpartum.

Method of study: We studied 98 pregnant women by determining their TPOAb levels in early pregnancy, as well as their serum thyrotropin and free thyroid (fT4) levels at 6 and 12 months postpartum. Furthermore, they answered a questionnaire and physical examination was performed by only one examiner.

Results: Of the 98 women, 10 were positive TPOAb in early pregnancy. The overall risk of PPTD within 1 year of follow-up was 10.2% (95% CI 4.1-16.3). Risk of PPTD was significantly higher among women with a family history of thyroid disease, TPOAb positive and presenting goiter in early pregnancy. The sensitivity, specificity and positive predictive value of TPOAb in PPTD prediction were 60.0%, 95.5% and 60%. Restricting screening to women with a family history of thyroid disease or presenting goiter increases the positive predictive value from 60% to 82.4%.

Conclusion: Our results suggest that TPOAb could be used as a screening test for PPTD prediction at least among women who present a high risk of developing PPTD.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / blood*
  • Autoantigens / immunology*
  • Female
  • Follow-Up Studies
  • Humans
  • Iodide Peroxidase / immunology*
  • Iron-Binding Proteins / immunology*
  • Mass Screening / methods*
  • Postpartum Period / blood*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Trimester, First / immunology
  • Risk Assessment
  • Risk Factors
  • Sensitivity and Specificity
  • Surveys and Questionnaires
  • Thyroid Diseases / blood
  • Thyroid Diseases / diagnosis*
  • Thyroid Diseases / etiology
  • Thyroid Diseases / immunology
  • Thyrotropin / blood
  • Thyroxine / blood
  • Time Factors

Substances

  • Autoantibodies
  • Autoantigens
  • Iron-Binding Proteins
  • Thyrotropin
  • TPO protein, human
  • Iodide Peroxidase
  • Thyroxine