Endocrinol Metab.  2022 Jun;37(3):387-391. 10.3803/EnM.2022.301.

Euthyroid Thyroperoxidase Antibody Positivity during Pregnancy, to Treat or Not to Treat?

• Korevaar TIM

• KMID: 2531382
• DOI: http://doi.org/10.3803/EnM.2022.301

Abstract

Thyroperoxidase antibody (TPOAb) positivity is a well-known risk factor for thyroid dysfunction during pregnancy and is associated with a suboptimal response to thyroidal stimulation by human chorionic gonadotropin. About 75% of TPOAb positive women are euthyroid and there seems to be a higher risk of predominantly miscarriage and preterm birth in this subgroup. Nonetheless, clinical decision making with regards to gestational levothyroxine treatment remains difficult due to a lack of large randomized trials. Future studies assessing dose-dependent associations and additional biomarkers that can distinguish low-risk from high-risk individuals will be key in disentangling the crude clinical data.

Keyword

Pregnancy; Thyroid gland; Thyroperoxidase antibodies

Figure

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  Fig. 1. Thyroid stimulation by human chorionic gonadotropin (hCG) according to thyroperoxidase antibody (TPOAb) status (top right) and presumed physiological changes throughout pregnancy with TPOAb negative women in red and TPOAb positive women in black. Adapted from Korevaar et al. [13], with permission from Oxford University Press. FT4, free thyroxine.

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