The association of thyroid autoantibody in euthyroid women with early pregnancy loss

Introduction: Thyroid autoantibodies are seen in a significant percentage of women of reproductive age. Even in euthyroid women, a positive anti thyroid antibody has been linked to an increased risk of spontaneous and recurrent pregnancy loss, as well as premature birth. However, in Bangladesh context, data is still insufficient to practice thyroid autoantibodies screening for prevention of early pregnancy loss. Methods: This case-control study was carried out in the Obstetrics and Gynecology department of Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladeshfrom July 2021 to June 2022. The study period was 12 months. A total of 80 patients was enrolled according to inclusion and exclusion criteria following ethical clearance. Informed written consent was taken from each patient. Patients were enrolled dividing in two groups: group 1 and group 2. Group 1 included euthyroid patients presenting with early pregnancy loss and group 2 included apparently healthy pregnant women with a gestational age from 8 to 20 weeks. Each patient was subjected to detailed history taking, thorough physical examination, and relevant investigations, including thyroglobulin antibody and thyroperoxidase antibody. For data collection, a semi-structured questionnaire was used. Collected data were checked for errors and analyzed by Statistical Packages for social sciences (SPSS 22). Results: Mean age of the patients was 24.13±4.49 (SD) years in group 1 and 23.98±4.76 (SD) in group 2. Baseline characteristics were statistically similar in both groups. Regarding obstetric profile, multiparity and multigravidity were significantly higher in patients with early pregnancy loss (p<.05).Though TSH (Thyroid stimulating hormone) was statistically similar in both groups (1.88±1.00 mIU/L in group 1 and 1.85±0.95mIU/L in group 2, p>.05), both thyroglobulin antibody (Tg-Ab) (184.7±202.4 IU/ml vs 115.3 ±103.3 IU /ml, p<.05) and thyroid peroxidase antibody (TPO-Ab) (53.55±121.8 I U/ml vs 19.97±57.29I U/ml, p<.05) were significantly higher in women with early pregnancy loss (group-1). Conclusion: This study observed significantly higher frequency of thyroid antibody in patients with early pregnancy loss comparing to the women with normal early pregnancy. However, further larger study is recommended.