Risk Management and Healthcare Policy (Mar 2021)
Variations in the Antithyroid Antibody Titre During Pregnancy and After Delivery
Abstract
Chuyu Li,1– 3,* Na Zhang,1– 3,* Jing Zhou,1– 3 Wingting Leung,1– 3 Hans-Jürgen Gober,4 Zengshu Huang,1– 3 Xinyao Pan,1– 3 Lijia Chen,1– 3 Liang Guan,5,6 Ling Wang1– 3 1Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 2The Academy of Integrative Medicine of Fudan University, Shanghai, People’s Republic of China; 3Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, People’s Republic of China; 4Department of Pharmacy, Neuromed Campus, Kepler University Hospital, Linz, 4020, Austria; 5Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China; 6Department of Nuclear Medicine, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liang GuanRuijin Hospital of Shanghai Jiaotong University, 197 Ruijin 2nd Road, Huangpu District, Shanghai, 200025, People’s Republic of ChinaTel +86 18917762612Fax + 86-21-6433 3548Email [email protected] WangObstetrics & Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai, 200011, People’s Republic of ChinaTel + 86-18221815182Fax + 86-021-63457331Email [email protected]: Immunosuppression occurs during pregnancy, and the antithyroid antibody titre drops, rebounding after delivery. We aimed to determine variations in antithyroid antibody titres during pregnancy and after delivery.Methods: This retrospective study was conducted in a single centre. Antibody titres of 142 patients were measured to assess variations in the levels of thyroid-stimulating hormone receptor antibodies (TRAbs), thyroid peroxidase antibodies (TPOAbs), and thyroid globulin antibodies (TgAbs). We compared the titres of each antibody between adjacent time periods (eg, first trimester (T1) vs second trimester (T2), T2 vs third trimester (T3), T3 vs the postpartum period (PP)) by paired t-test or the Wilcoxon test. Then, we analysed data from patients with complete laboratory examination results in all four periods with the Friedman test, performing comparisons among groups.Results: In the TgAb group, significant differences existed between T1 and T2 and between T2 and T3 in the LT4 subgroup and between T1 and T2 in the no-medication subgroup. In the TRAb group, significant differences existed between T1 and T2 in the LT4 subgroup. In the TPOAb group, significant differences existed among each group in the LT4 subgroup, and there were significant differences between T1 and T2 and between T2 and T3 in the no-medication subgroup. The Friedman test showed that the P-values were 0.013 and 0.004 in the LT4 and no-medication subgroups of the TgAb group, respectively; 0.122 in the LT4 subgroup of the TRAb group; and < 0.001 and 0.272 in the LT4 and no-medication subgroups of the TPOAb group, respectively. In the LT4 subgroup of the TgAb group, the P-values for comparisons of time periods were 0.602 between T1 and T2, 0.602 between T2 and T3, 0.006 between T1 and T3, and 0.602 between T3 and PP. In the no-medication subgroup of the TgAb group, the P-values were 0.078 between T1 and T2, 1.000 between T2 and T3, 0.011 between T1 and T3, and 0.078 between T3 and PP. In the LT4 subgroup of the TPOAb group, the P-values were 0.09 between T1 and T2, 0.014 between T2 and T3, < 0.001 between T1 and T3, and 0.772 between T3 and PP.Conclusion: We can conclude that the TgAb and TPOAb titres dropped during pregnancy.Keywords: autoimmune thyroid disease, thyroid-stimulating hormone receptor antibody, thyroid peroxidase antibody, thyroid globulin antibody
