Positive thyroid peroxidase antibody titer is associated with dysphoric moods during pregnancy and postpartum

Abstract

Objective: To examine general dysphoric moods prospectively in women who tested positive for thyroid peroxidase autoantibodies (TPO) during pregnancy and postpartum.

Design: Longitudinal, correlational, two-group, observational study.

Setting: Perinatal clinics.

Participants: Six-hundred thirty-one (631) pregnant women.

Methods: Participants were screened for TPO antibodies, and 63 were TPO euthyroid positive. All were asked to continue into a 6-month postpartum follow-up and 47 agreed. A comparison group of TPO negative women (n = 72) was randomly selected for follow-up. Women were visited monthly for 6 months and a blood sample was obtained to measure thyroid stimulating hormone (TSH), a targeted physical exam was conducted, and a thyroid symptom checklist (Perceived Stress Scale) and the Profile of Mood States (POMS) checklist were completed.

Results: Pregnant TPO-positive women had significantly higher depressive symptoms and were more likely to score higher than 20 on the POMS depression (POMS-D) scale than TPO-negative women. The TPO-positive women had significantly higher depression, anger, and total mood disturbance scores postpartum than TPO-negative women, regardless of development of postpartum thyroiditis (n = 25).

Conclusions: Our results suggest that the presence of TPO autoantibodies alone in euthyroid pregnant and postpartum women increases the possibility of negative dysphoric moods, especially depressive symptoms that cannot be explained by stress or demographic factors.

Figure 1

Mean Profile of Mood States (POMS) depression Scores across time (Mean +/− Standard Error of the Mean)