Thyroid autoimmunity and adverse pregnancy outcomes: A multiple center retrospective study.

Area of Science:

• Endocrinology
• Obstetrics
• Immunology

Background:

• The link between thyroid autoimmunity (TAI) and adverse pregnancy outcomes remains debated, with unclear dose-dependent associations.
• Existing research lacks comprehensive clarification on the specific risks posed by TAI during pregnancy.

Purpose of the Study:

• To investigate the association between TAI and various maternal and fetal-neonatal complications.
• To determine the dose-dependent effects of thyroid autoantibodies on pregnancy outcomes.

Main Methods:

• A multi-center retrospective cohort study involving 27,408 singleton pregnancies.
• Comparison of maternal and fetal-neonatal complications between TAI and control groups.
• Logistic regression analysis to assess risk and dose-dependent effects of thyroid autoantibodies, adjusting for confounding factors.

Main Results:

• Thyroid autoimmunity was independently associated with increased risks of pregnancy-induced hypertension, gestational diabetes mellitus, and neonatal NICU admission.
• Elevated thyroid autoantibody (TPOAb and TGAb) concentrations correlated with higher risks of pregnancy-induced hypertension, small for gestational age, and NICU admission.
• Both TPOAb and TGAb levels showed a negative association with neonatal birthweight.

Conclusions:

• Thyroid autoimmunity is an independent risk factor for adverse pregnancy outcomes, including pregnancy-induced hypertension, gestational diabetes mellitus, low birthweight, and NICU admission.
• A dose-dependent relationship exists between thyroid autoantibody levels (TPOAb, TGAb) and specific adverse outcomes, highlighting the importance of antibody concentration.