Thyroid Diseases Identified as an Independent Risk Factor for Platelet Antibody Positivity in Pregnant Women: A...

Platelet antibodies are associated with adverse pregnancy outcomes, such as miscarriage and fetal/neonatal alloimmune thrombocytopenia (FNAIT). However, data on their prevalence and risk factors in the southern Chinese population remain limited. This study aimed to investigate the prevalence of platelet antibodies and their risk factors in pregnant women from southern China, with a particular focus on their association with thyroid diseases.

Blood samples from 5,037 pregnant women presenting for delivery between June 30, 2022, and April 7, 2024, were screened for platelet antibodies via the solid-phase agglutination test. Participants were categorized as platelet antibody positive or negative based on the test results. Clinical data were compared between the two groups. Binary logistic regression analysis was performed to identify independent risk factors for platelet antibody positivity.

The overall platelet antibody positivity rate was 7.68%. The positivity increased significantly with both a greater number of pregnancies and a history of miscarriage. Notably, thyroid diseases were strongly associated with platelet antibodies: women with thyroid diseases had a significantly higher positivity rate of 11.55%. Specifically, Hashimoto's thyroiditis (HT) and thyroid nodules were identified as significant independent risk factors in the binary logistic regression analysis. Other significant independent risk factors included a history of blood transfusion, three or more pregnancies, three or more miscarriages, and thalassemia.

This study provides novel evidence of a significant association between maternal thyroid disorders (particularly HT and thyroid nodules) and a higher prevalence of platelet antibodies during pregnancy. These findings highlight the importance of considering thyroid status in antenatal care and suggest a potential benefit of proactive platelet antibody screening, especially in women with thyroid diseases, to help mitigate associated risks such as miscarriage and FNAIT.