European Journal of Biomedical and Pharmaceutical Sciences

POSTPARTUM THYROID DYSFUNCTION; CLINICAL VALUATION AND PROPHETIC INFLUENCE OF TPOAB AND PSYCHIATRIC AFFECTIVE ILLNESS

Moaaz Mohammed Nisar* and Mohammad Salman Muqtadir

ABSTRACT

Postpartum thyroid dysfunction (PPTD) occurs in 5-7 % of women, with hypothyroidism developing in 25 % of these after 3–6 yr. Authors have determined the prophetic implication of thyroid peroxidase antibody (TPOAb), human leukocyte antigen haplotype, and postpartum thyroid status on the development of thyroid dysfunction 77–81 months after PPTD. Thyroid dysfunction occurred in 46% of group 1 vs. 4% of group 2 (P, 0.001) and 24.5% of groups 1 and 2 vs. 1.4% of group 3 (P, 0.001). Factors predictive of thyroid dysfunction included a hypothyroid form of PPTD, TSH more than 20 mU/L, and higher TPOAb levels (213.8 kIU/L in group 1 vs. 131.8 kIU/L in group 2; P, 0.002) during the postpartum period. Although TPOAb was higher in group 1 than in group 2 at follow-up (166 vs. 97.7 kIU/L; P, 0.03), there was no significant fall in TPOAb levels within either group during the period of follow-up. Human leukocyte antigen DR10 was lower in those who developed late thyroid dysfunction. These data, representing the longest follow-up of PPTD women, clearly show that the hypothyroid form of PPTD and high TPOAb levels of long term thyroid dysfunction. This compares with a relative risk of 12.9 for TPOAb- and PPTD-positive women, who remained euthyroid at the end of the first postpartum year, and 2.8 for TPOAb-positive but PPTD-negative women, all compared to TPOAb-negative women.

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