Title: Prevalence of Thyroid autoimmunity in pregnancy and its effect in pregnancy outcome

Authors: Sanchayan Sinha, Arpita Mandal, Soma Gupta, Chandana Das

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.40

Abstract

Background: Thyroid dysfunction is common in pregnancy. It is important for growth & development of foetus. The most important cause of thyroid dysfunction in iodine sufficient areas is autoimmune thyroiditis. Thyroid peroxidase is an important enzyme for thyroid hormone biosynthesis. Anti TPO antibody is found in autoimmune thyroiditis which causes adverse fetomaternal outcome by subtle alteration of thyroid reserve.

Aims and Objectives: The study aims to find out anti TPO antibody level in pregnancy and thereafter to determine prevalence of thyroid autoimmunity. Moreover, it aims to find difference in fetomaternal outcome according to the anti TPO antibody status.

Materials and Methods: The study included the estimation of anti TPO antibody of 142 women during delivery. On the basis of values of anti TPO antibody level prevalence of thyroid autoimmunity was calculated & the patients were divided as Anti TPO positive (n=26) & Anti TPO negative (n=116). Maternal outcome of pregnancy was measured in terms of ante partum & postpartum haemorrhage, anaemia. Foetal outcome was measured in terms of APGAR score & birth weight of baby. The data were tabulated & analysed using standard statistical method.

Result: Prevalence of thyroid autoimmunity was 18.3%. The incidence of adverse outcome was statistically significant in thyroid autoimmunity for maternal anaemia [p value 0.0096], Low birth weight [p value 0.026], Low APGAR score [p value < 0.0001]. TSH level of the baby measured from cord blood was more in thyroid autoimmunity.

Conclusion: Feto-maternal outcome was found to be adverse in patients with thyroid autoimmunity. Ante partum &post-partum haemorrhage was found to be more in Anti TPO Antibody positive patients. Low birth weight & low APGAR score were observed more in cases of babies born to mothers with thyroid autoimmunity.

Keywords: Thyroid autoimmunity, Anti TPO antibody, Antepartum haemorrhage, Postpartum haemorrhage, APGAR score, Pregnancy.

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