Relationship between thyroid autoantibodies and thyroid function in pregnant women during different ges-tation period / 实用医学杂志

ABSTRACT

Objective To investigate the changes of serum thyroid peroxidase(TPOAb)and thyroglobulin antibody(TGAb)and their relationship with thyroid function in pregnant women during different gestation period Methods Totally 341 cases of primiparae were selected from October 2015 to September 2016 and levels of se-rum thyrotropin(TSH),free triiodothyronine(FT3),free thyroxine(FT4),thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TgAb)were measured by electrochemiluminescence. Results The prevalence of thy-roid dysfunction and positive serum thyroid autoantibodies were 13.2%and 12.61%respectively,which mainly oc-curred in early and middle pregnancy. Thyroid dysfunction in subjects included hypothyroidism(0.59%),subclini-cal hypothyroidism(7.92%),low T4 hyperlipidemia(3.23%),hyperthyroidism(0.88%)and subclinical hyper-thyroidism(0.59%). The positive rate of TPOAb was significantly higher than that of TgAb(10.85% vs. 4.99%, P<0.01). The positive rate of TPOAb in women with thyroid disfunction was significantly higher than that in those with normal thyroid function(44.44%vs. 5.74%,P<0.01). TSH level of TPOAb positive subjects was higher than that of TPOAb negative ones(P<0.05,P<0.01);TSH level of TPOAb positive subjects with thyroid dysfunction were significantly higher than those of TPOAb negative subjects and TPOAb positive pregnant women but with nor-mal thyroid function(P < 0.01). The hypothyroidism prevalence rate of TPOAb positive subjects was significantly higher than that of TPOAb negative subjects in early and middle stage of pregnancy (P < 0.01). The prevalence rates of subclinical hypothyroidism ,low T4 hyperlipidemia and clinical hypothyroidism were significantly higher in TPOAb positive pregnant women(29.17%,20.83% and 8.33%)than those in TPOAb negative pregnant women (P < 0.01). Conclusions Thyroid dysfunction is closely related to positive status of TPOAb and TgAb in pregnancy,which could influence the outcome of pregnancy and the development of offspring. Since levels of TSH, FT3 and FT4 could not fully reveal thyroid function ,it is necessary to monitor the status of TPOAb and TgAb as early as possible for the early diagnosis and treatment of thyroid disease in pregnancy.