Association of Thyroid Peroxidase Antibodies and Thyroglobulin Antibodies with Thyroid Function in Pregnancy: An Individual Participant Data Meta-Analysis

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dc.article.numberCD011703
dc.contributor.authorBliddal, Sofie
dc.contributor.authorDerakhshan, Arash
dc.contributor.authorXiao, Yi
dc.contributor.authorChen, Liang-Miao
dc.contributor.authorMannisto, Tuija
dc.contributor.authorAshoor, Ghalia
dc.contributor.authorTao, Fangbiao
dc.contributor.authorBrown, Suzanne J.
dc.contributor.authorVafeiadi, Marina
dc.contributor.authorItoh, Sachiko
dc.contributor.authorGrineva, Elena Nikolaevna
dc.contributor.authorTaylor, Peter
dc.contributor.authorGhafoor, Farkhanda
dc.contributor.authorVaidya, Bijay
dc.contributor.authorHattersley, Andrew
dc.contributor.authorMosso, Lorena
dc.contributor.authorOken, Emily
dc.contributor.authorKishi, Reiko
dc.contributor.authorAlexander, Erik K.
dc.contributor.authorMaraka, Spyridoula
dc.contributor.authorHuang, Kun
dc.contributor.authorChaker, Layal
dc.contributor.authorBassols, Judit
dc.contributor.authorPirzada, Amna
dc.contributor.authorLopez-Bermejo, Abel
dc.contributor.authorBoucai, Laura
dc.contributor.authorPeeters, Robin P.
dc.contributor.authorPearce, Elizabeth N.
dc.contributor.authorNelson, Scott McGill
dc.contributor.authorChatzi, Leda
dc.contributor.authorVrijkotte, Tanja G.
dc.contributor.authorPopova, Polina V.
dc.contributor.authorWalsh, John P.
dc.contributor.authorNicolaides, Kypros H.
dc.contributor.authorSuvanto, Eila
dc.contributor.authorLu, Xuemian
dc.contributor.authorPop, Victor J. M.
dc.contributor.authorForman, Julie Lyng
dc.contributor.authorKorevaar, Tim I. M.
dc.contributor.authorFeldt-Rasmussen, Ulla
dc.date.accessioned2025-05-01T10:30:52Z
dc.date.available2025-05-01T10:30:52Z
dc.date.issued2022
dc.description.abstractObjectives: Thyroid autoimmunity is common in pregnant women and associated with thyroid dysfunction and adverse obstetric outcomes. Most studies focus on thyroid peroxidase antibodies (TPOAbs) assessed by a negative-positive dichotomy and rarely take into account thyroglobulin antibodies (TgAbs). This study aimed at determining the association of TPOAbs and TgAbs, respectively, and interdependently, with maternal thyroid function.Methods: This was a meta-analysis of individual participant cross-sectional data from 20 cohorts in the Consortium on Thyroid and Pregnancy. Women with multiple pregnancy, pregnancy by assisted reproductive technology, history of thyroid disease, or use of thyroid interfering medication were excluded. Associations of (log2) TPOAbs and TgAbs (with/without mutual adjustment) with cohort-specific z-scores of (log2) thyrotropin (TSH), free triiodothyronine (fT3), total triiodothyronine (TT3), free thyroxine (fT4), total thyroxine (TT4), or triiodothyronine:thyroxine (T3:T4) ratio were evaluated in a linear mixed model.Results: In total, 51,138 women participated (51,094 had TPOAb-data and 27,874 had TgAb-data). Isolated TPOAb positivity was present in 4.1% [95% confidence interval, CI: 3.0 to 5.2], isolated TgAb positivity in 4.8% [CI: 2.9 to 6.6], and positivity for both antibodies in 4.7% [CI: 3.1 to 6.3]. Compared with antibody-negative women, TSH was higher in women with isolated TPOAb positivity (z-score increment 0.40, CI: 0.16 to 0.64) and TgAb positivity (0.21, CI: 0.10 to 0.32), but highest in those positive for both antibodies (0.54, CI: 0.36 to 0.71). There was a dose-response effect of higher TPOAb and TgAb concentrations with higher TSH (TSH z-score increment for TPOAbs 0.12, CI: 0.09 to 0.15, TgAbs 0.08, CI: 0.02 to 0.15). When adjusting analyses for the other antibody, only the association of TPOAbs remained statistically significant. A higher TPOAb concentration was associated with lower fT4 (p < 0.001) and higher T3:T4 ratio (0.09, CI: 0.03 to 0.14), however, the association with fT4 was not significant when adjusting for TgAbs (p = 0.16).Conclusions: This individual participant data meta-analysis demonstrated an increase in TSH with isolated TPOAb positivity and TgAb positivity, respectively, which was amplified for individuals positive for both antibodies. There was a dose-dependent association of TPOAbs, but not TgAbs, with TSH when adjusting for the other antibody. This supports current practice of using TPOAbs in initial laboratory testing of pregnant women suspected of autoimmune thyroid disease. However, studies on the differences between TPOAb- and TgAb-positive women are needed to fully understand the spectrum of phenotypes.
dc.description.funderJoseph and Silvana Melara Cancer Research Fund (Toronto, ON, Canada)
dc.format.extent185 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1089/thy.2022.0083
dc.identifier.eissn1557-9077
dc.identifier.issn1050-7256
dc.identifier.pubmedid35555289
dc.identifier.scieloidS0718-69242020000300109
dc.identifier.scopusidSCOPUS_ID:85219032355
dc.identifier.urihttps://doi.org/10.1089/thy.2022.0083
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/103675
dc.identifier.wosidWOS:000822759000011
dc.information.autorucEscuela de Medicina; Mosso Gomez Lorena Montserrat; 0000-0001-5420-7099; 88201
dc.issue.numero7
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final840
dc.pagina.inicio828
dc.relation.ispartofFASEB journal : official publication of the Federation of American Societies for Experimental Biology
dc.revistaTHYROID
dc.rightsregistro bibliográfico
dc.subjectmeta-analysis
dc.subjectpregnancy
dc.subjectthyroglobulin antibodies
dc.subjectthyroid
dc.subjectthyroid autoimmunity
dc.subjectthyroid peroxidase antibodies
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods11 Sustainable cities and communities
dc.subject.odspa11 Ciudades y comunidades sostenibles
dc.titleAssociation of Thyroid Peroxidase Antibodies and Thyroglobulin Antibodies with Thyroid Function in Pregnancy: An Individual Participant Data Meta-Analysis
dc.typeartículo
dc.volumen32
sipa.codpersvinculados88201
sipa.indexWOS
sipa.trazabilidadCarga WOS-SCOPUS;01-05-2025
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