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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Volume 42, Issue 1 (Jan 2014)

Issues

Does the presence of thyroid antibodies affect the course and outcome of pregnancy in type 1 diabetic women?

Vasiliki Sarantopoulou
  • First Endocrine Section, Diabetes Centre, Alexandra Hospital, Athens, Greece
/ Vasiliki Vasileiou
  • First Endocrine Section, Diabetes Centre, Alexandra Hospital, Athens, Greece
/ Leda Sarika
  • First Endocrine Section, Diabetes Centre, Alexandra Hospital, Athens, Greece
/ George Philippou
  • First Endocrine Section, Diabetes Centre, Alexandra Hospital, Athens, Greece
/ Maria Alevizaki
  • Endocrine Unit, Department of Clinical Therapeutics, School of Medicine, Athens University, Athens, Greece
/ Aris Antsaklis
  • First Department of Obstertrics and Gynecology, University of Athens, Athens, Greece
/ Eleni Anastasiou
  • Corresponding author
  • First Endocrine Section, Diabetes Centre, Alexandra Hospital, Athens, Greece
  • Email:
Published Online: 2013-08-29 | DOI: https://doi.org/10.1515/jpm-2012-0273

Abstract

Objective: The aim of the study was to evaluate the significance of the presence of thyroid peroxidase autoantibodies (anti-TPO Abs) in type 1 diabetes mellitus (DM1) pregnant women relative to the course of pregnancy and, especially, with regard to metabolic control, thyroid function, maternal complications and neonatal outcome.

Methods: In a prospective observational study of 91 DM1 women with singleton pregnancies, anti-TPO, anti-thyroglobulin, thyroid-stimulating hormone (TSH), and free thyroxine index (T4/thyroid binding capacity) were measured in each trimester. At each visit, HbA1c, body mass index, and units of insulin per kilogram were recorded, as were complications and pregnancy outcome.

Results: Twenty-one (27%) of the 78 women who met the inclusion criteria presented with positive anti-TPO Abs. There were no differences regarding glycemic control (HbA1c) or insulin dose. First-trimester TSH levels were significantly higher in the anti-TPO-positive group than in the anti-TPO-negative group. Finally, no differences were observed regarding diabetic or obstetric complications and neonatal outcome.

Conclusion: One fourth of DM1 pregnant women presented with positive anti-TPO Abs. However, the presence of anti-TPO Abs does not seem to be related with worse metabolic control or adverse pregnancy outcome. Further investigation is needed; meanwhile, the effort for early treatment of thyroid dysfunction and strict metabolic control in all DM1 women should be continued.

Keywords: Diabetes type 1; metabolic control; thyroid antibodies; TSH

References

  • [1]

    Alvarez-Marfany M, Roman SH, Drexler AJ, Robertson C, Stagnaro-Green A. Long-term prospective study of postpartum thyroid dysfunction in women with insulin dependent diabetes mellitus. J Clin Endocrinol Metab. 1994;79:10–6.

  • [2]

    Bech K, Høier-Madsen M, Feldt-Rasmussen U, Jensen BM, Mølsted-Pedersen L, Kühl C. Thyroid function and autoimmune manifestations in insulin-dependent diabetes mellitus during and after pregnancy. Acta Endocrinol (Copenh). 1991;124:534–9. [PubMed]

  • [3]

    Challis JR, Lockwood CJ, Myatt L, Norman JE, Strauss JF III, Petraglia F. Inflammation and pregnancy. Reprod Sci. 2009;16:206–15. [Web of Science] [Crossref]

  • [4]

    De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:2543–65. [PubMed] [Crossref]

  • [5]

    Dupont WD, Plummer WD. Power and sample size calculations: a review and computer program. Control Clin Trials. 1990;11:116–28. [PubMed] [Crossref]

  • [6]

    Fernandez-Soto L, Gonzalez A, Lobón JA, Lopez JA, Peterson CM, Escobar-Jiménez F. Thyroid peroxidase autoantibodies predict poor metabolic control and need for thyroid treatment in pregnant IDDM women. Diabetes Care. 1997;20:1524–8. [Crossref]

  • [7]

    Gallas PR, Stolk RP, Bakker K, Endert E, Wiersinga WM. Thyroid dysfunction during pregnancy and in the first postpartum year in women with diabetes mellitus type 1. Eur J Endocrinol. 2002;147:443–51. [PubMed] [Crossref]

  • [8]

    Glinoer D. Miscarriage in women with positive anti-TPO antibodies: is thyroxine the answer? J Clin Endocrinol Metab. 2006;91:2500–2. [Crossref] [PubMed]

  • [9]

    Glinoer D, Riahi M, Grün JP, Kinthaert J. Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J Clin Endocrinol Metab. 1994;79:197–204. [PubMed]

  • [10]

    Jaeger C, Hatziagelaki E, Petzoldt R, Bretzel RG, Reinhard G. Comparative analysis of organ-specific autoantibodies and celiac disease-associated antibodies in type 1 diabetic patients, their first-degree relatives, and healthy control subjects, Diabetes Care. 2001;24:27–32.

  • [11]

    Li Y, Shan Z, Teng W, Yu X, Li Y, Fan C, et al. Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25–30 months. Clin Endocrinol (Oxf). 2010;72:825–9.

  • [12]

    Männistö T, Vääräsmäki M, Pouta A, Hartikainen AL, Ruokonen A, Surcel HM, et al. Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population-based cohort study. J Clin Endocrinol Metab. 2009;94:772–29. [Crossref] [Web of Science] [PubMed]

  • [13]

    Negro R, Formoso G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab. 2006;91:2587–91. [PubMed] [Crossref]

  • [14]

    Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med. 1995;12:622–7. [Crossref] [PubMed]

  • [15]

    Poppe K, Glinoer D. Thyroid autoimmunity and hypothyroidism before and during pregnancy. Hum Reprod Update. 2003;9:149–61. [Crossref] [PubMed]

  • [16]

    Roldán MB, Alonso M, Barrio R. Thyroid autoimmunity in children and adolescents with Type 1 diabetes mellitus. Diabetes Nutr Metab. 1999;12:27–31.

  • [17]

    Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21:1081–125. [Crossref]

  • [18]

    Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. Br Med J. 2011;342:d2616.

  • [19]

    Vestgaard M, Nielsen LR, Rasmussen AK, Damm P, Mathiesen ER. Thyroid peroxidase antibodies in pregnant women with type 1 diabetes: impact on thyroid function, metabolic control and pregnancy outcome. Acta Obstet Gynecol Scand. 2008;87:1336–42. [Web of Science]

About the article

Corresponding author: Eleni Anastasiou, First Endocrine Section, Diabetes Centre, Alexandra Hospital, 80 Vas. Sofias St, Athens 11528, Greece, E-mail:


Received: 2012-11-21

Accepted: 2013-07-15

Published Online: 2013-08-29

Published in Print: 2014-01-01



Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2012-0273. Export Citation

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