Variations in the Antithyroid Antibody Titre During Pregnancy and After Delivery

Chuyu Li; Na Zhang; Jing Zhou; Wingting Leung; Hans-Jürgen Gober; Zengshu Huang; Xinyao Pan; Lijia Chen; Liang Guan; Ling Wang

doi:10.2147/RMHP.S279975

Variations in the Antithyroid Antibody Titre During Pregnancy and After Delivery

Risk Manag Healthc Policy. 2021 Mar 1:14:847-859. doi: 10.2147/RMHP.S279975. eCollection 2021.

Authors

Chuyu Li^#^{1

2

3}, Na Zhang^#^{1

2

3}, Jing Zhou^{1

2

3}, Wingting Leung^{1

2

3}, Hans-Jürgen Gober⁴, Zengshu Huang^{1

2

3}, Xinyao Pan^{1

2

3}, Lijia Chen^{1

2

3}, Liang Guan^{5

6}, Ling Wang^{1

2

3}

Affiliations

¹ Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
² The Academy of Integrative Medicine of Fudan University, Shanghai, People's Republic of China.
³ Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, People's Republic of China.
⁴ Department of Pharmacy, Neuromed Campus, Kepler University Hospital, Linz, 4020, Austria.
⁵ Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
⁶ Department of Nuclear Medicine, Ruijin Hospital North, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Background: Immunosuppression occurs during pregnancy, and the antithyroid antibody titre drops, rebounding after delivery. We aimed to determine variations in antithyroid antibody titres during pregnancy and after delivery.

Methods: This retrospective study was conducted in a single centre. Antibody titres of 142 patients were measured to assess variations in the levels of thyroid-stimulating hormone receptor antibodies (TRAbs), thyroid peroxidase antibodies (TPOAbs), and thyroid globulin antibodies (TgAbs). We compared the titres of each antibody between adjacent time periods (eg, first trimester (T1) vs second trimester (T2), T2 vs third trimester (T3), T3 vs the postpartum period (PP)) by paired t-test or the Wilcoxon test. Then, we analysed data from patients with complete laboratory examination results in all four periods with the Friedman test, performing comparisons among groups.

Results: In the TgAb group, significant differences existed between T1 and T2 and between T2 and T3 in the LT4 subgroup and between T1 and T2 in the no-medication subgroup. In the TRAb group, significant differences existed between T1 and T2 in the LT4 subgroup. In the TPOAb group, significant differences existed among each group in the LT4 subgroup, and there were significant differences between T1 and T2 and between T2 and T3 in the no-medication subgroup. The Friedman test showed that the P-values were 0.013 and 0.004 in the LT4 and no-medication subgroups of the TgAb group, respectively; 0.122 in the LT4 subgroup of the TRAb group; and <0.001 and 0.272 in the LT4 and no-medication subgroups of the TPOAb group, respectively. In the LT4 subgroup of the TgAb group, the P-values for comparisons of time periods were 0.602 between T1 and T2, 0.602 between T2 and T3, 0.006 between T1 and T3, and 0.602 between T3 and PP. In the no-medication subgroup of the TgAb group, the P-values were 0.078 between T1 and T2, 1.000 between T2 and T3, 0.011 between T1 and T3, and 0.078 between T3 and PP. In the LT4 subgroup of the TPOAb group, the P-values were 0.09 between T1 and T2, 0.014 between T2 and T3, <0.001 between T1 and T3, and 0.772 between T3 and PP.

Conclusion: We can conclude that the TgAb and TPOAb titres dropped during pregnancy.

Keywords: autoimmune thyroid disease; thyroid globulin antibody; thyroid peroxidase antibody; thyroid-stimulating hormone receptor antibody.