■在妊娠期间测量血清甲状腺过氧化物酶自身抗体(TPOAb)作为产后甲状腺炎(PPT)风险的经典标志物,可预测1/3至1/2女性的PPT。很少有研究测量妊娠期间的血清甲状腺激素Ab(THAb),并且没有作为PPT的可能标记。
在412名妇女中,从妊娠7到11周一直到分娩后12个月进行随访,我们测量了THAb(T3。IgM,T3.IgG,T14.IgM,T14.IgG),进入研究(妊娠7-11周)时的甲状腺球蛋白自身抗体(TgAb)和TPOAb。
■63名女性(15.3%)出现PPT,在34/63(54%)中进展为永久性甲状腺功能减退症(PH)。THAb+ve为21/412名女性(5.1%),那些随后开发PPT的人的频率更高(12/63[19.0%]与9/349[2.6%],P=4.6×10-8),和PH亚组(26.5%[9/34]vs.10.3%[10/29],P=0.12)。TgAb和/或TPOAb+ve的9/76女性(11.8%)出现THAb阳性,而TgAb和TPOAb阴性的12/336女性(3.6%,P=0.0031)。在这9个THAb+ve中,TgAb和/或TPOAb+ve女性,与3/11(27.3%,P=0.0011)THAb+ve,TgAb和/或TPOAb阴性女性。在这9个和3个PPT女性中,8和1进展为PH(88.9%和33.3%,分别,P=0.12)。
■THAb的妊娠阳性极大地增强了TPOAb/TgAb的妊娠阳性的PPT的预测性。然而,它们的低频率(5.1%)和它们的灵敏度(17.5%[21/63])与它们代替TPOAb/TgAb的应用背道而驰。
UNASSIGNED: Measurement of serum thyroperoxidase autoantibodies (TPOAb) during gestation as a classical marker for the risk of postpartum thyroiditis (PPT) predicts PPT in 1/3 to 1/2 of women. Very few studies have measured serum thyroid hormone Ab (THAb) during gestation, and none as a possible marker for PPT.
UNASSIGNED: In 412 women who were followed up from 7 to 11 weeks of gestation through 12 months after delivery, we measured THAb (T3.IgM, T3.IgG, T4.IgM, T4.IgG), thyroglobulin autoantibodies (TgAb) and TPOAb at study entry (7-11 week of gestation).
UNASSIGNED: Sixty-three women (15.3%) developed PPT, which progressed to permanent hypothyroidism (PH) in 34/63 (54%). THAb+ve were 21/412 women (5.1%), the frequency being greater in those who then developed PPT (12/63 [19.0%] vs. 9/349 [2.6%], P = 4.6 × 10-8), and in the PH subgroup (26.5% [9/34] vs. 10.3% [10/29], P = 0.12). THAb positivity occurred in 9/76 women (11.8%) who were TgAb and/or TPOAb+ve compared to 12/336 women who were TgAb and TPOAb negative (3.6%, P = 0.0031). Of these 9 THAb+ve, TgAb and/or TPOAb+ve women, all (100%) developed PPT compared to 3/11 (27.3%, P = 0.0011) THAb+ve, TgAb and/or TPOAb negative women. Of these 9 and 3 PPT women, 8 and 1 progressed to PH (88.9% and 33.3%, respectively, P = 0.12).
UNASSIGNED: Gestational positivity of THAb enhance enormously the predictivity for PPT of gestational positivity of TPOAb/TgAb. However, their low frequency (5.1%) and their sensitivity (17.5% [21/63]) go against their application in lieu of TPOAb/TgAb.