Original article / research
Status of Thyroid Peroxidase Antibodies in Pregnant Women and Association with Obstetric and Perinatal Outcomes in Tertiary Care Center
Dr. Smriti Agrawal,
Associate Professor, Department of Obstetrics and Gynaecology, King George Medical University,
Lucknow-226003, Uttar Pradesh, India.
Introduction: Thyroid dysfunction is reported in 8.25% of pregnant women in Indian subcontinent. About two thirds of these women have subclinical hypothyroidism and the rest have overt hypothyroidism.
Aim: To study the prevalence and impact of Thyroid Peroxidase (TPO) antibodies on obstetric and perinatal outcome in a tertiary health centre.
Materials and Methods: This was a prospective cohort study conducted in antenatal clinic of Department of Obstetrics and Gynaecology in collaboration with Department of Biochemistry at King George Medical University, Lucknow, India. Total 230 antenatal women upto 20 weeks of gestational age were recruited, venous blood sample was assessed for serum TSH and TPO Ab and women were classified as subclinical or overt hypothyroid. Subsequently, serum TSH was repeated at interval of 4-6 weeks after initiation of treatment. All the enrolled women were followed for obstetric and perinatal outcome.
Results: The prevalence of TPO Ab in pregnant women was 49 (21.3%). The proportion of hypothyroid women was higher in TPO positive group as compared to TPO negative group (48.98% V/s 27.22%, p=0.01). There were 10 abortions, 4 of them had TPO Ab V/s 6 who were TPO Ab negative. Among TPO Ab positive hypothyroid women 37.5% had preterm labour Vs 5.26% in TPO Ab positive euthyroid women (p-value=0.04). GDM was observed more in TPO Ab positive group (14.2%vs 7.56% p=0.157). There was no difference in terms of caesarean section or neonatal outcome in the study.
Conclusion: The study shows the high prevalence (21.3%) of TPO antibody in antenatal women. Hypothyroidism was more prevalent in TPO Ab positive group. Preterm labour was seen more often in hypothyroid women with TPO Ab.
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