E-ISSN: 2619-9467

Contents    Cover    Publication Date: 22 Jun 2022
Year 2022 - Volume 32 - Issue 2

Open Access

Peer Reviewed

SCIENTIFIC LETTER
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Anti-Thyroid Peroxidase Antibody and Hypothyroidism in Recurrent Pregnancy Miscarriage

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JCOG. 2022;32(2):67-71
DOI: 10.5336/jcog.2021-86703
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Thyroid disorders are one of the endocrine diseases that may develop during pregnancy. Thyroid autoimmunity (TAI) is commonly prevalent among these diseases in women of childbearing age. TAI includes thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies, and thyrotropin receptor antibodies. However, TPOAb is the most common antithyroid autoantibodies observed in women with recurrent miscarriage (RM) history. Although the precise mechanisms of the TPOAb's role in RM are not fully understood, multiple studies have found that the presence of TPOAb at a high level may increase the risk of recurrent pregnancy loss. The literature in this article was conducted based on published databases in PubMed, Web of Science, Google Scholar, and some international organizations It aims to emphasize the importance of screening for TPOAb in women with RM. It concludes that, according to published studies, the TPOAb could be considered as a good indicator of women at risk of RM.
REFERENCES:
  1. El Hachem H, Crepaux V, May-Panloup P, Descamps P, Legendre G, Bouet PE. Recurrent pregnancy loss: current perspectives. Int J Womens Health. 2017;9:331-45. [Crossref]  [PubMed]  [PMC] 
  2. Larsen EC, Christiansen OB, Kolte AM, Macklon N. New insights into mechanisms behind miscarriage. BMC Med. 2013;11:154. [Crossref]  [PubMed]  [PMC] 
  3. Yan J, Sripada S, Saravelos SH, Chen ZJ, Egner W, Li TC. Thyroid peroxidase antibody in women with unexplained recurrent miscarriage: prevalence, prognostic value, and response to empirical thyroxine therapy. Fertil Steril. 2012;98(2):378-82. [Crossref]  [PubMed] 
  4. Liu H, Shan Z, Li C, Mao J, Xie X, Wang W, et al. Maternal subclinical hypothyroidism, thyroid autoimmunity, and the risk of miscarriage: a prospective cohort study. Thyroid. 2014;24(11):1642-9. [Crossref]  [PubMed]  [PMC] 
  5. Wang JW, Liao XX, Li T. Thyroid autoimmunity in adverse fertility and pregnancy outcomes: timing of assisted reproductive technology in AITD Women. J Transl Int Med. 2021;9(2):76-83. [Crossref]  [PubMed]  [PMC] 
  6. Godlewska M, Krasuska W, Czarnocka B. Biochemical properties of thyroid peroxidase (TPO) expressed in human breast and mammary-derived cell lines. PLoS One. 2018;13(3):e0193624. [Crossref]  [PubMed]  [PMC] 
  7. Meena M, Chopra S, Jain V, Aggarwal N. The effect of anti-thyroid peroxidase antibodies on pregnancy outcomes in euthyroid women. J Clin Diagn Res. 2016;10(9):QC04-QC07. [PubMed]  [PMC] 
  8. Pang ALY, Chan WY. Molecular basis of diseases of the endocrine system. In: Coleman W, Tsongalis G, eds. Essential Concepts in Molecular Pathology. 1st ed. Academic Press; 2010. p.289-307. [Crossref]  [PubMed] 
  9. Zhang Y, Wang H, Pan X, Teng W, Shan Z. Patients with subclinical hypothyroidism before 20 weeks of pregnancy have a higher risk of miscarriage: a systematic review and meta-analysis. PLoS One. 2017;12(4):e0175708. [Crossref]  [PubMed]  [PMC] 
  10. Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018;14(5):301-16. [Crossref]  [PubMed] 
  11. Min Y, Wang X, Chen H, Yin G. The exploration of Hashimoto's Thyroiditis related miscarriage for better treatment modalities. Int J Med Sci. 2020;17(16):2402-15. [Crossref]  [PubMed]  [PMC] 
  12. Ralli M, Angeletti D, Fiore M, D'Aguanno V, Lambiase A, Artico M, et al. Hashimoto's thyroiditis: an update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation. Autoimmun Rev. 2020;19(10):102649. [Crossref]  [PubMed] 
  13. Akamizu T, Amino N. Hashimoto's Thyroiditis. 2017 Jul 17. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, et al, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. [PubMed] 
  14. Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014;13(4-5):391-7. [Crossref]  [PubMed] 
  15. Dhillon-Smith RK, Coomarasamy A. TPO antibody positivity and adverse pregnancy outcomes. Best Pract Res Clin Endocrinol Metab. 2020;34(4):101433. [Crossref]  [PubMed] 
  16. Cellini M, Santaguida MG, Stramazzo I, Capriello S, Brusca N, Antonelli A, et al. Recurrent pregnancy loss in women with hashimoto's thyroiditis with concurrent non-endocrine autoimmune disorders. Thyroid. 2020;30(3):457-62. [Crossref]  [PubMed] 
  17. Mehran L, Tohidi M, Sarvghadi F, Delshad H, Amouzegar A, Soldin OP, et al. Management of thyroid peroxidase antibody euthyroid women in pregnancy: comparison of the american thyroid association and the endocrine society guidelines. J Thyroid Res. 2013;2013:542692. [Crossref]  [PubMed]  [PMC] 
  18. Feldthusen AD, Pedersen PL, Larsen J, Toft Kristensen T, Ellervik C, Kvetny J. Impaired fertility associated with subclinical hypothyroidism and thyroid autoimmunity: the danish general suburban population study. J Pregnancy. 2015;2015:132718. Erratum in: J Pregnancy. 2017; 2017:9864034. [Crossref]  [PubMed]  [PMC] 
  19. Godines-Enriquez MS, Miranda-Velásquez S, Enríquez-Pérez MM, Arce-Sánchez L, Martínez-Cruz N, Flores-Robles CM, et al. Prevalence of thyroid autoimmunity in women with recurrent pregnancy loss. Medicina (Kaunas). 2021;57(2):96. [Crossref]  [PubMed]  [PMC] 
  20. Weghofer A, Himaya E, Kushnir VA, Barad DH, Gleicher N. The impact of thyroid function and thyroid autoimmunity on embryo quality in women with low functional ovarian reserve: a case-control study. Reprod Biol Endocrinol. 2015;13:43. [Crossref]  [PubMed]  [PMC] 
  21. Xie J, Jiang L, Sadhukhan A, Yang S, Yao Q, Zhou P, et al. Effect of antithyroid antibodies on women with recurrent miscarriage: A meta-analysis. Am J Reprod Immunol. 2020;83(6):e13238. [Crossref]  [PubMed]  [PMC] 
  22. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 2017;27(3):315-89. Erratum in: Thyroid. 2017;27(9): 1212. [Crossref]  [PubMed] 
  23. 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. BMJ. 2011;342:d2616. [Crossref]  [PubMed]  [PMC] 
  24. Ali MS, Rahman RMA, Wahba NS, Gaber MN. Relation between anti-thyroid peroxidase antibody and recurrent pregnancy loss: a case control study. Evidence Based Women s Health Journal. 2020;10(2):176-80. [Crossref] 
  25. Rajput R, Yadav T, Seth S, Nanda S. Prevalence of thyroid peroxidase antibody and pregnancy outcome in euthyroid autoimmune positive pregnant women from a tertiary care center in haryana. Indian J Endocrinol Metab. 2017;21(4):577-80. [Crossref]  [PubMed]  [PMC] 
  26. Vissenberg R, Fliers E, van der Post JA, van Wely M, Bisschop PH, Goddijn M. Live-birth rate in euthyroid women with recurrent miscarriage and thyroid peroxidase antibodies. Gynecol Endocrinol. 2016;32(2):132-5. [Crossref]  [PubMed] 
  27. Ianiro G, Mangiola F, Di Rienzo TA, Bibbò S, Franceschi F, Greco AV, et al. Levothyroxine absorption in health and disease, and new therapeutic perspectives. Eur Rev Med Pharmacol Sci. 2014;18(4):451-6. [PubMed] 
  28. Ferrara R, Ientile V, Arcoraci V, Ferrajolo C, Piccinni C, Fontana A, et al. Treatment pattern and frequency of serum TSH measurement in users of different levothyroxine formulations: a population-based study during the years 2009-2015. Endocrine. 2017;58(1):143-52. [Crossref]  [PubMed] 
  29. Nazarpour S, Ramezani Tehrani F, Simbar M, Tohidi M, Alavi Majd H, Azizi F. Effects of levothyroxine treatment on pregnancy outcomes in pregnant women with autoimmune thyroid disease. Eur J Endocrinol. 2017;176(2):253-65. [Crossref]  [PubMed] 
  30. Meena A, Nagar P. Pregnancy outcome in euthyroid women with anti-thyroid peroxidase antibodies. J Obstet Gynaecol India. 2016;66(3):160-5. [Crossref]  [PubMed]  [PMC] 
  31. Korevaar TIM. Preconception levothyroxine treatment in euthyroid TPOAb-positive women does not affect miscarriage or preterm birth rates. Clinical Thyroidology. 2019;31(5):189-94. [Crossref] 
  32. Negro R, Schwartz A, Stagnaro-Green A. Impact of levothyroxine in miscarriage and preterm delivery rates in first trimester thyroid antibody-positive women with TSH less than 2.5 mIU/L. J Clin Endocrinol Metab. 2016;101(10):3685-90. [Crossref]  [PubMed] 
  33. Visser WE, Peeters RP. Interpretation of thyroid function tests during pregnancy. Best Pract Res Clin Endocrinol Metab. 2020;34(4):101431. [Crossref]  [PubMed] 
  34. Plowden TC, Schisterman EF, Sjaarda LA, Perkins NJ, Silver R, Radin R, et al. Thyroid-stimulating hormone, anti-thyroid antibodies, and pregnancy outcomes. Am J Obstet Gynecol. 2017;217(6):697.e1-7.e7. [Crossref]  [PubMed]  [PMC] 
  35. Leiva P, Schwarze JE, Vasquez P, Ortega C, Villa S, Crosby J, et al. There is no association between the presence of anti-thyroid antibodies and increased reproductive loss in pregnant women after ART: a systematic review and meta-analysis. JBRA Assist Reprod. 2017;21(4):361-5. [Crossref]  [PubMed]  [PMC]