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Levothyroxine Treatment in Euthyroid Pregnant Women with Autoimmune Thyroid Disease: Effects on Obstetrical Complications

The journal of clinical endocrinology and metabolism, 2006-07, Vol.91 (7), p.2587-2591 [Peer Reviewed Journal]

2006 INIST-CNRS ;ISSN: 0021-972X ;EISSN: 1945-7197 ;DOI: 10.1210/jc.2005-1603 ;PMID: 16621910 ;CODEN: JCEMAZ

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Title:
Levothyroxine Treatment in Euthyroid Pregnant Women with Autoimmune Thyroid Disease: Effects on Obstetrical Complications
Author: Negro, Roberto ; Formoso, Gianni ; Mangieri, Tiziana ; Pezzarossa, Antonio ; Dazzi, Davide ; Hassan, Haslinda
Subjects: Abortion, Spontaneous - epidemiology ; Abortion, Spontaneous - immunology ; Adolescent ; Adult ; Autoantibodies - blood ; Autoimmune Diseases - drug therapy ; Biological and medical sciences ; Endocrinopathies ; Female ; Fundamental and applied biological sciences. Psychology ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Iodide Peroxidase - immunology ; Medical sciences ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Obstetric Labor, Premature - epidemiology ; Obstetric Labor, Premature - immunology ; Pregnancy ; Pregnancy Complications - immunology ; Pregnancy Outcome ; Thyroid Diseases - drug therapy ; Thyroid Diseases - immunology ; Thyroid Function Tests ; Thyroid. Thyroid axis (diseases) ; Thyrotropin - blood ; Thyroxine - blood ; Thyroxine - therapeutic use ; Vertebrates: endocrinology
Is Part Of: The journal of clinical endocrinology and metabolism, 2006-07, Vol.91 (7), p.2587-2591
Description: Context: Euthyroid women with autoimmune thyroid disease show impairment of thyroid function during gestation and seem to suffer from a higher rate of obstetrical complications. Objective: We sought to determine whether these women suffer from a higher rate of obstetrical complications and whether levothyroxine (LT4) treatment exerts beneficial effects. Design: This was a prospective study. Setting: The study was conducted in the Department of Obstetrics and Gynecology. Patients: A total of 984 pregnant women were studied from November 2002 to October 2004; 11.7% were thyroid peroxidase antibody positive (TPOAb+). Intervention: TPOAb+ patients were divided into two groups: group A (n = 57) was treated with LT4, and group B (n = 58) was not treated. The 869 TPOAb− patients (group C) served as a normal population control group. Main Outcome Measures: Rates of obstetrical complications in treated and untreated groups were measured. Results: At baseline, TPOAb+ had higher TSH compared with TPOAb−; TSH remained higher in group B compared with groups A and C throughout gestation. Free T4 values were lower in group B than groups A and C after 30 wk and after parturition. Groups A and C showed a similar miscarriage rate (3.5 and 2.4%, respectively), which was lower than group B (13.8%) [P < 0.05; relative risk (RR), 1.72; 95% confidence interval (CI), 1.13–2.25; and P < 0.01; RR = 4.95; 95% CI = 2.59–9.48, respectively]. Group B displayed a 22.4% rate of premature deliveries, which was higher than group A (7%) (P < 0.05; RR = 1.66; 95% CI = 1.18–2.34) and group C (8.2%) (P < 0.01; RR = 12.18; 95% CI = 7.93–18.7). Conclusions: Euthyroid pregnant women who are positive for TPOAb develop impaired thyroid function, which is associated with an increased risk of miscarriage and premature deliveries. Substitutive treatment with LT4 is able to lower the chance of miscarriage and premature delivery.
Publisher: Bethesda, MD: Endocrine Society
Language: English
Identifier: ISSN: 0021-972X
EISSN: 1945-7197
DOI: 10.1210/jc.2005-1603
PMID: 16621910
CODEN: JCEMAZ
Source: GFMER Free Medical Journals
MEDLINE

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Levothyroxine Treatment in Euthyroid Pregnant Women with Autoimmune Thyroid Disease: Effects on Obstetrical Complications

2006 INIST-CNRS ;ISSN: 0021-972X ;EISSN: 1945-7197 ;DOI: 10.1210/jc.2005-1603 ;PMID: 16621910 ;CODEN: JCEMAZ

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