Role of thyroid peroxidase antibodies in the outcome of pregnancy.

OBJECTIVE: To assess the prevalence of Thyroid peroxidase (TPO) auto antibodies among pregnant women and its relation with their pregnancy outcome. DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: The study was carried out at Zayed Medical Complex, Lahore, in the department of Obs/Gynae and NHRC from July 2000 to July 2002. PATIENTS AND METHODS: The study included 1,500 Euthyroid pregnant women, ages 18 – 40, registered for antenatal care at Obs/Gynae department. Previous fertility history was recorded and thyroid peroxidase antibody level was assessed by ELISA method. A cut off value of TPO antibody of upto 100 U/ml was considered negative and more than 100 U/ml was considered positive.The cases were followed for the outcome of their pregnancy and compared with TPO antibody levels.

A comprehensive proforma was used to collect the data. RESULTS: The prevalence of positive TPO autoantibodies was found to be 11.2%. The raised TPO autoantibodies were found to have higher risk of abortion (O.R 49.2) and prematurity (O.R.8.1). The complications were found to be significantly raised among positive TPO autoantibodies cases, when analysed by parity and age of mother at time of registration. CONCLUSION: Thyroid autoimmune diseases among euthyroid pregnant women may contribute to low-birth-weight of neonates and high abortion rate in all pregnancies. Raised levels of TPO autoantibody is a good marker to assess early hypothyroidism state and should form a screening modality in Pakistan.

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