Effects of Thyroperoxidase Antibody and Thyroglobulin Antibody on
Maternal and Neonatal Outcomes in Pregnant Women
Authors: Wang Li , Tang Yi , Yuan Yi , Yu Lin , Jin Bai , Xia Jun , Yuan Qingxin 
Published: February 2022

The aim of the study was to evaluate the effects of thyroperoxidase antibody
(TPOAb) and thyroglobulin antibody (TgAb) on maternal and neonatal adverse
outcomes in pregnant women. A total of 296 singleton pregnant women were
classified into four groups according to the thyroid auto-antibody in the first
trimester. Finally, there were 97 women in TPOAb positive group
(TPOAb+/TgAb–), 35 in TgAb positive group
(TPOAb–/TgAb+), 85 in TPOAb and TgAb positive group
(TPOAb+/TgAb+), and 79 in TPOAb and TgAb negative group
(TPOAb–/TgAb–). Thyroid function, TPOAb, and TgAb were
checked during pregnancy and followed up at 6 weeks, 3 months, 6 months, 9
months, and 12 months postpartum. Levothyroxine sodium tablets could be taken to
maintain euthyroid antepartum. Thyroid function of women with postpartum
thyroiditis (PPT) were followed up at 2 and 3 years postpartum. We observed the
incidence of PPT, premature rupture of membranes (PROM), placental abruption,
placenta previa, polyhydramnios, oligohydramnios, postpartum hemorrhage, preterm
birth, and low birth Weight in the four groups. 19.93% of the women had
PPT. The incidence of PPT in TPOAb+/TgAb–,
TPOAb–/TgAb+, TPOAb+/TgAb+groups
was significantly higher than that in TPOAb–/TgAb–
group, respectively (16.49 vs. 6.33%, 22.86 vs. 6.33%, 35.29 vs.
6.33%, p <0.05). The incidence of PPT in
TPOAb+/TgAb+group was significantly higher than that in
TPOAb+/TgAb– group (35.29 vs. 16.49%, p
<0.01). PPT occurred as early as 6 weeks postpartum, but mainly at 3 and
6 months postpartum in the four groups (62.50%, 75.00%,
70.00%, 80.00%). All PPT in TPOAb–/TgAb–
group occurred within 6 months postpartum, while it was found at 9 months or 12
months postpartum in other three groups. There was no classical form of PPT in
TPOAb–/TgAb– group, while in the other three groups, all
three types (classical form, isolated thyrotoxicosis, isolated hypothyroidism)
existed. At 2 years postpartum of the women with PPT, the rate of euthyroidism
in TPOAb+/TgAb+group was significantly lower than that
in TPOAb–/TgAb– group (p <0.05). At 3 years
postpartum of the women with PPT, the rate of euthyroidism in
TPOAb+/TgAb–, TPOAb–/TgAb+, and
TPOAb+/TgAb+groups were significantly lower than that in
TPOAb–/TgAb– group (p <0.05). The values of
TPOAb and TgAb postpartum were significantly higher than those during pregnancy
(p <0.05). The incidence of PROM in TPOAb+/TgAb–
group was significantly higher than that in TPOAb–/TgAb–
group (32.99 vs. 17.72%, p <0.05). The binary logistic
regression for PPT showed that the OR value of TPOAb was 2.263 (95% CI
1.142–4.483, p=0.019). The OR value of TgAb was 3.112
(95% CI 1.700–5.697, p=0.000). In conclusion, pregnant
women with positive thyroid auto-antibodies had an increased risk of PPT and a
reduced rate of euthyroidism at 2 and 3 years postpartum. TPOAb is associated
with the incidence of PROM. Both of TPOAb and TgAb were independent risk factors
for PPT. TgAb deserves more attention when studying autoimmune thyroid disease
(AITD) combined with pregnancy.