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Postpartum thyroid dysfunction: clinical assessment and relationship to psychiatric affective morbidity
G N Kent1, B G Stuckey, J R Allen
1Division of Clinical Pathology, The Western Australian Centre for Pathology and Medical Research, Nedlands, Western Australia. neil.kent@health.wa.gov.au
Clinical Endocrinology
|December 3, 1999
Summary
Postpartum thyroid dysfunction (PPTD) affects 11.5% of women. While PPTD is common, it doesn't present with distinct clinical or psychiatric symptoms, making diagnosis reliant on thyroid function tests.
Area of Science:
- Endocrinology
- Obstetrics & Gynecology
- Psychiatry
Background:
- Postpartum thyroid dysfunction (PPTD) is a common transient condition with variable prevalence.
- The clinical and psychiatric impact of PPTD remains unclear.
Purpose of the Study:
- To determine the point prevalence of PPTD in Australian women at 6 months postpartum.
- To assess the specific clinical and psychiatric morbidity associated with PPTD.
Main Methods:
- A random sample of 748 Caucasian women aged 20-45 years, 4.5-5.5 months postpartum, were assessed.
- Biochemical thyroid function tests (TSH, free T4, antibodies) and psychiatric screening (GHQ-28, DSM-III-R) were performed.
- Standardized clinical indices for hypothyroidism and hyperthyroidism were used for assessment.
Main Results:
- The prevalence of PPTD was 11.5% (95% CI 9.2-13.8%).
- No significant relationship was found between PPTD status and current depression.
- Women with PPTD reported more anxiety symptoms compared to controls (P < 0.05).
Conclusions:
- PPTD is highly prevalent postpartum.
- Clinical and psychiatric signs and symptoms do not differentiate PPTD cases from controls.
- Diagnosis of PPTD relies solely on abnormal thyroid function tests.