Thyroid Autoantibodies in Pregnancy and its Implications

Abstract

Introduction: Inadequate thyroid hormone during pregnancy could adversely affect the child's intelligence. In addition to play- ing an important role in the development of a growing fetus, proper thyroid hormone levels also help to minimize the chance of any thyroid disorders after delivery. Post partum thyroiditis usually presents 3-6 months after delivery. A prior history of thyroiditis, the presence of anti-thyroid antibodies and a previous history of post partum thyroiditis increases the risk of developing post partum thyroiditis.
Objective: The present study is aimed at evaluating the prevalence of anti-thyroid antibodies and subsequent post partum thyroidi- tis among pregnant women in an urban population in Kerala.
Materials and Methods: 262 pregnant women aged 19-40 yrs. who could be followed upto their delivery and post partum period were selected for the study.
Observations: Thyroid Autoantibodies were assessed (antithyroglobulin -ATG and antimicrosomal - TPO) in 262 pregnant women. Twenty nine percent of patients (76) had thyroid Autoantibodies; (53% of this group had only TPO positivity, 17% ATG positivity and 30% had both positivity). Of the 76 patients with antibodies positive, 5 were (7%) hypothyroid, while only one patient without antibodies (0.5%) was hypothyroid (difference significant P. value 0.008). Post partum thyroiditis developed in 5.2% of patients with positive antibodies while the prevalence was only 0.5% (one patient) in antibodies negative patients - this difference was also statistically significant (P value 0.02).
Conclusions: The detection of thyroid autoantibodies will help to predict post partum thyroiditis at a later state in pregnant women.