Live-birth rate in euthyroid women with recurrent miscarriage and thyroid peroxidase antibodies

Abstract

Thyroid autoimmunity with normal thyroid function is associated with recurrent miscarriage (RM), but the association with live birth is less clear. Therefore, we determined the association between thyroid peroxidase antibodies (TPO-Ab) and live-birth rate (LBR) in a retrospective cohort of euthyroid women with unexplained RM. We included 202 women of which 28 were TPO-Ab positive (13.9%) and 174 were TPO-Ab negative. TPO-Ab positive women (n = 10) without levothyroxine treatment had a lower LBR (29%) compared to TPO-Ab negative women (51%) (HR 0.23, 0.07–0.72, p = 0.012). The LBR in women with TPO-Ab receiving levothyroxine was not different compared women without TPO-Ab (60% versus 51%, p = 0.50). In conclusion, TPO-Ab are associated with a lower LBR in euthyroid women with unexplained RM and these women may benefit from treatment with levothyroxine.

Chinese abstract

甲状腺功能正常伴甲状腺自体免疫与复发性流产（RM）相关，但是否与活产率相关尚不清楚。因此，我们对甲状腺功能正常的原因不明的复发性流产妇女进行回顾性队列研究，探讨甲状腺过氧化物酶抗体（TPO-Ab）与活产率（LBR）之间的关系。202名妇女中28名TPO-Ab阳性(13.9%)，174名妇女TPO-Ab阴性。TPO-Ab 阳性 (n = 10) 未用左甲状腺素治疗者活产率较低 (29%) 与 TPO-Ab 阴性患者（51%）相比（HR 0.23, 0.07 - 0.72, p = 0.012）。TPO-Ab阳性接受左甲状腺素治疗者与TPO-Ab阴性患者活产率无明显差别（60%与51%, p = 0.5）。结论：对于甲状腺功能正常的不明原因复发性流产妇女，TPO-Ab与较低的活产率相关，而这类患者可经左甲状腺素治疗获益。

• Levothyroxine
• live-birth rate
• pregnancy rate
• recurrent miscarriage
• thyroid autoimmunity
• thyroid peroxidase antibodies

Declaration of interest

All authors state that no competing financial interests exist.