Open AccessThyroid peroxidase antibodies in pregnant women with type 1 diabetes: Impact on thyroid function, metabolic control and pregnancy outcome
Author(s) -
VESTGAARD MARIANNE,
NIELSEN LENE RINGHOLM,
RASMUSSEN ÅSE KROGH,
DAMM PETER,
MATHIESEN ELISABETH R.
Publication year - 2008
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1080/00016340802499261
Subject(s) - medicine , thyroid peroxidase , pregnancy , thyroid function , levothyroxine , endocrinology , gestational diabetes , type 1 diabetes , diabetes mellitus , population , thyroid , anti thyroid autoantibodies , gestation , autoantibody , antibody , immunology , genetics , environmental health , biology
Abstract Objective . In pregnant women with type 1 diabetes, we evaluated whether the presence of thyroid peroxidase autoantibodies (anti‐TPO) was associated with changes in thyroid function, metabolic control and pregnancy outcome. Design/setting . Prospective study, Denmark. Population . Ninety‐six consecutive pregnant women with type 1 diabetes. Twenty‐five healthy pregnant controls. Methods. At 8, 14, 21, 27 and 33 weeks, the diabetic women self‐monitored plasma glucose (SMPG) (8/day) for 3 days and had blood samplings obtained. Main outcome measures. Thyroid‐stimulating hormone (TSH), free thyroxin (T 4 ), hemoglobin A 1C (HbA 1C ), anti‐TPO, pregnancy outcome. Results. Anti‐TPO was detected in 31 (32%) of the pregnant diabetic women compared with two women (8%) in the healthy controls ( p = 0.015). The presence of anti‐TPO was associated with higher TSH at 8 ( p <0.0001) and 14 weeks ( p <0.05) and lower free T 4 at 8 weeks ( p <0.05) compared with anti‐TPO negative women. Twenty untreated anti‐TPO positive women had higher TSH compared with untreated, anti‐TPO negative women ( p <0.05), but comparable free T 4 . At inclusion, 25% had TSH above the recommended treatment goal for levothyroxine (TSH>2.5 mIU/l), most prevalently among anti‐TPO positive women. Sixteen women (17%) were treated for thyroid disorder during pregnancy. No differences were detected between the diabetic women with and without anti‐TPO regarding HbA 1C , insulin dose, median SMPG or pregnancy outcome. Conclusions. Anti‐TPO was present in one‐third of pregnant women with type 1 diabetes and associated with slightly higher TSH, but not poorer glycemic control or adverse birth outcome. A total of 17% of women with type 1 diabetes were treated for thyroid disorder during pregnancy.