Association of maternal isolated thyroid peroxidase antibody positive in the first trimester with fetal growth.
- Author:
Jin Hui XU
1
;
Na HAN
2
;
Tao SU
2
;
Li Zi LIN
3
;
Yue Long JI
1
;
Shuang ZHOU
1
;
He Ling BAO
1
;
Zheng LIU
1
;
Shu Sheng LUO
1
;
Xiang Rong XU
1
;
Hai Jun WANG
1
Author Information
1. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China.
2. Tongzhou Maternal and Child Health Hospital of Beijing, Beijing 101101, China.
3. Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
- Publication Type:Journal Article
- Keywords:
Fetal development;
Pregnancy trimester, first;
Thyroid di-seases;
Thyroid peroxidase antibody
- MeSH:
Pregnancy;
Female;
Humans;
Pregnancy Trimester, First;
Iodide Peroxidase;
Cohort Studies;
Reproducibility of Results;
Fetal Development;
Fetal Weight;
Fetal Growth Retardation;
Ultrasonography, Prenatal
- From:
Journal of Peking University(Health Sciences)
2023;55(5):886-892
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the association of isolated thyroid peroxidase antibody (TPOAb) positive in the first trimester with fetal growth.
METHODS:A total of 16 446 pregnant women were included in the birth cohort study, whose last menstrual period was between May 2016 and April 2019 and with singleton pregnancy. Maternal serum samples were collected when they firstly came for prenatal care in the first trimester. The pregnant women were consecutively seen and followed in the hospital and the information of pregnant women was extracted from the electronic medical information system. The pregnant women were divided into isolated TPOAb positive group (n=1 654) and euthyroid group (n=14 792). Three fetal ultrasound examinations were scheduled during the routine prenatal visits at the hospital and were performed by trained sonographers. All fetal growth indicators were quantified as gestational age- and gender- adjusted standard deviation score (Z-score) using the generalized additive models for location, scale and shape (GAMLSS). Fetal growth indicators included estimated fetal weight (EFW), abdominal circumference (AC), biparietal diameter (BPD), femur length (FL) and head circumference (HC). Fetal growth restriction (FGR) was defined as AC or EFW Z-score＜3rd centile based on clinical consensus. Generalized estimating equation (GEE) analysis was applied to assess the association of maternal isolated TPOAb positive with fetal growth. The generalized linear model was further used to analyze the association between isolated TPOAb positive and fetal growth indicator at different gestational ages when the fetal growth indicator was significantly associated with isolated TPOAb positive in the GEE mo-del.
RESULTS:The median gestational age at three ultrasound measurements was 23.6 (23.3, 24.1), 30.3 (29.7, 30.9), 37.3 (37.0, 37.7) weeks, respectively. The BPD Z-score was higher in isolated TPOAb positive women, compared with the euthyroid pregnant women after adjustment (β=0.057, 95%CI: 0.014-0.100, P=0.009). The generalized linear model showed the BPD Z-score was higher in the isolated TPOAb positive women at the end of 21-25 weeks (β=0.052, 95%CI: 0.001-0.103, P=0.044), 29-32 weeks (β=0.055, 95%CI: 0.004-0.107, P=0.035) and 36-40 weeks (β=0.068, 95%CI: 0.011-0.125, P=0.020), compared with the euthyroid pregnant women. There was no difference in other fetal growth indicators (EFW, AC, FL and HC) and FGR between the isolated TPOAb positive and euthyroid pregnant women.
CONCLUSION:The BPD Z-score was slightly increased in the isolated TPOAb positive pregnant women in the first trimester, while other fetal growth indicators were not changed. The reproducibility and practical significance of this result need to be confirmed.
