Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun;37(3):387-391.
doi: 10.3803/EnM.2022.301. Epub 2022 Jun 29.

Euthyroid Thyroperoxidase Antibody Positivity during Pregnancy, to Treat or Not to Treat?

Tim I M Korevaar  1
Affiliations

Euthyroid Thyroperoxidase Antibody Positivity during Pregnancy, to Treat or Not to Treat?

Tim I M Korevaar. Endocrinol Metab (Seoul). 2022 Jun.

Abstract

Thyroperoxidase antibody (TPOAb) positivity is a well-known risk factor for thyroid dysfunction during pregnancy and is associated with a suboptimal response to thyroidal stimulation by human chorionic gonadotropin. About 75% of TPOAb positive women are euthyroid and there seems to be a higher risk of predominantly miscarriage and preterm birth in this subgroup. Nonetheless, clinical decision making with regards to gestational levothyroxine treatment remains difficult due to a lack of large randomized trials. Future studies assessing dose-dependent associations and additional biomarkers that can distinguish low-risk from high-risk individuals will be key in disentangling the crude clinical data.

Keywords: Pregnancy; Thyroid gland; Thyroperoxidase antibodies.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Thyroid stimulation by human chorionic gonadotropin (hCG) according to thyroperoxidase antibody (TPOAb) status (top right) and presumed physiological changes throughout pregnancy with TPOAb negative women in red and TPOAb positive women in black. Adapted from Korevaar et al. [13], with permission from Oxford University Press. FT4, free thyroxine.
See this image and copyright information in PMC

References

    1. Casey BM, Dashe JS, Wells CE, McIntire DD, Leveno KJ, Cunningham FG. Subclinical hyperthyroidism and pregnancy outcomes. Obstet Gynecol. 2006;107(2 Pt 1):337–41. - PubMed
    1. Bliddal S, Derakhshan A, Xiao Y, Chen L, Mannisto T, Ashoor G, et al. Association of thyroid peroxidase antibodies and thyroglobulin antibodies with thyroid function in pregnancy: an individual participant data meta-analysis. Thyroid. 2022 May 20; doi: 10.1089/thy.2022.0083. [Epub]. - DOI - PubMed
    1. Consortium on Thyroid and Pregnancy—Study Group on Preterm Birth. Korevaar TI, Derakhshan A, Taylor PN, Meima M, Chen L, et al. Association of thyroid function test abnormalities and thyroid autoimmunity with preterm birth: a systematic review and meta-analysis. JAMA. 2019;322:632–41. - PMC - PubMed
    1. De Leo S, Pearce EN. Autoimmune thyroid disease during pregnancy. Lancet Diabetes Endocrinol. 2018;6:575–86. - PubMed
    1. Yehuda M, Wang CH, Pak Y, Chiu KC, Gianoukakis AG. Parity and risk of thyroid autoimmunity based on the NHANES (2001-2002, 2007-2008, 2009-2010, and 2011-2012) J Clin Endocrinol Metab. 2017;102:3437–42. - PubMed

LinkOut - more resources