Thyroperoxidase and thyroglobulin antibodies in early pregnancy and placental abruption
OBJECTIVE: To estimate the relationship between thyroid antibodies and placental abruption. METHODS: This cohort study assesses thyroperoxidase and thyroglobulin antibodies in relation to placental abruption among 10,062 women with singleton viable pregnancies (from the First and Second Trimester Risk of Aneuploidy [FaSTER] trial). A thyroperoxidaseantibody cutoff of 50 international units/mL is used for comparison with published data from another cohort. RESULTS: Women with elevated thyroperoxidase antibody levels in the first and second trimesters have a higher rate of placental abruption than antibody-negative women. This relationship is less strong in the first trimester (1.51% compared with 0.83%; odds ratio [OR], 1.83; 95% confidence interval [CI], 0.99–3.37) than in the second trimester (1.78% compared with 0.82%; OR, 2.20; 95% CI, 1.21–3.99). A similar, but weaker, relationship is present forthyroglobulin antibodies. Sixty-four of 782 thyroperoxidase antibody-positive pregnancies without abruption become negative by the second trimester; one pregnancy with abruptionbecomes antibody-positive. Odds ratios for pregnancies with both thyroperoxidase andthyroglobulin antibody elevations are also higher (first trimester: OR, 2.10; 95% CI, 0.91–4.86; second trimester: OR, 2.73; 95% CI, 1.17–6.33). CONCLUSION: The present data confirm an association between thyroid antibody elevations and placental abruption described in a recent report. These findings, however, do not provide support for recommending routine testing for thyroid antibodies during pregnancy. LEVEL OF EVIDENCE: II
Obstetrics and Gynecology
The American College of Obstetricians and Gynecologists
Digital Object Identifier (DOI)
Haddow, J., McClain, M., Palomaki, G., Neveux, L., Lambert-Messerlian, G, Canick, J., Malone, F., Porter, T., Nyberg, D., Bernstein, P., & D’Alton, M.. (2011). Thyroperoxidase and thyroglobulin antibodies in early pregnancy and placental abruption. Obstetrics and Gynecology, 117, 287-92.
Copyright © 2011, (C) 2011 The American College of Obstetricians and Gynecologists