The clinical spectrum of postpartum thyroid disease

The clinical and biochemical features of postpartum thyroid disease were analysed in 152 antithyroid peroxidase antibody-positive (anti-TPO + ve) women and compared with 239 anti-TPO-ve agematched control postpartum women. All were assessed monthly for up to 12 months postpartum. Seventy three anti-...

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Bibliographic Details
Published in:QJM : An International Journal of Medicine 1996-06, Vol.89 (6), p.429-436
Main Authors: Lazarus, J.H., Hall, R., Othman, S., Parkes, A.B., Richards, C.J., McCulloch, B., Harris, B.
Format: Article
Language:English
Subjects:
Adult
Autoantibodies - blood
Autoimmune Diseases - immunology
Biological and medical sciences
Endocrinopathies
Female
Follow-Up Studies
Humans
Hyperthyroidism - immunology
Hypothyroidism - immunology
Iodide Peroxidase - immunology
Medical sciences
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Pregnancy
Puerperal Disorders - immunology
Thyroid Diseases - complications
Thyroid Diseases - immunology
Thyroid. Thyroid axis (diseases)
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Summary:The clinical and biochemical features of postpartum thyroid disease were analysed in 152 antithyroid peroxidase antibody-positive (anti-TPO + ve) women and compared with 239 anti-TPO-ve agematched control postpartum women. All were assessed monthly for up to 12 months postpartum. Seventy three anti-TPO + ve women developed postpartum thyroiditis (PPT): 19.2= hyperthyroid alone, 49.3= hypothyroid alone, and 31.5= characterized by hyper- followed by hypothyroidism. None of the antibody-negative women developed any thyroid dysfunction. A significant increase in many of eleven symptoms of hypothyroidism and some of eight symptoms of hyperthyroidism compared to control women was observed in all anti-TPO+ve women, independent of thyroid status. This was particularly seen in women who later developed PPT when they were euthyroid, but was also observed in euthyroid anti-TPO+ve women who showed no decline of thyroid function during the postpartum period. Although PPT is usually transient, this condition, and the euthyroid antibody-positive state, may be associated with significant symptomatology, including an increased incidence of minor to moderate depression. Early recognition of this syndrome by antenatal screening of thyroid antibodies may contribute to improved management of women during the postpartum period.
ISSN:1460-2725
1460-2393
DOI:10.1093/qjmed/89.6.429