Antithyroid antibodies underlying thyroid abnormalities and miscarriage or pregnancy induced hypertension

Abstract

Objective: To assess whether asymptomatic abnormalities, including thyroid auto-antibodies, were associated with an abnormal miscarriage rate or a poor obstetric outcome.

Design: Prospective study of thyroid auto-antibodies and thyroid function in an unselected obstetric population.

Setting: Saint-Pierrie Hospital, Brussels, Belgium.

Subjects: Seven hundred and thirty consecutive pregnant women attending the antenatal clinic.

Main outcome measures: Miscarriage and pregnancy induced hypertension.

Results: Elevated antithyroperoxidase (TPO-Ab) and antithyroglobulin (TG-Ab) antibody titres are associated with an increased miscarriage rate. Also, asymptomatic thyroid abnormalities, mainly abnormal echo-structure but not antithyroid antibodies, are associated with pregnancy induced hypertension.

Conclusion: The presence of thyroid auto-antibodies during pregnancy constitutes a marker of increased risk of miscarriage and poor obstetric prognosis.