Raghunath Bhattacharyya1, Kasturi Mukherjee2, Anjan Das3, Madhuri Ranjana Biswas3, Sandip Roy Basunia3, Anindya Mukherjee4
1Department of G and O, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
2Department of Biochemistry, Kolkata Medical College, Kolkata, West Bengal, India.
3Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
4Department of Anaesthesiology, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India.
Aims: We assessed the impact of detecting anti-thyroid peroxidase antibodies (anti-TPO-Ab) in the first trimester of pregnancy on pregnancy outcomes and maternal thyroid function during the postpartum period. Materials and Methods: In a prospective study consisting 400 pregnant women (8-12 weeks pregnant) were screened for their thyroid profile and followed-up to 12 weeks postpartum. Patients with abnormal thyroid function at 12 weeks postpartum were further followed-up with repeated assessment of thyroid stimulating hormone (TSH) and serum-free thyroxine-4 levels at 8 weeks interval up to 12 months postpartum. Results: 11.5% of the subjects were positive for anti-TPO-Ab who had mean TSH level of 2.31 μIU/ml, which was significantly (P- 0.0001) higher than pregnant women negative for anti-TPO-Ab (1.73 μIU/ml). Increased incidence of miscarriage was observed in anti-TPO positive mothers when compared to antibody negative mothers. Postpartum thyroid dysfunction developed in 4.7% cases at 12 weeks, among them antibody positivity was observed in 81.25% of subjects. In 18.75% mothers positive for anti-TPO-Ab, the thyroid dysfunction persisted up to 12 months postpartum. Conclusions: Thyroid antibodies detected in early pregnancy seems to be predicting pregnancy complications and later maternal thyroid disease related morbidity.
Keywords: Outpatient department, postpartum thyroid dysfunction, postpartum thyroiditis, thyroid peroxidase antibody.