Does the presence of thyroid antibodies affect the course and outcome of pregnancy in type1 diabetic women?

V Sarantopoulou; G Philippou; V Vasileiou; P Lymberi; L Sarika; M Alevizaki; E Anastasiou

Introduction: In the literature there are only three papers so far, addressing the impact of thyroid antibodies (Anti-TPO) on pregnancy in Type1 Diabetic Women (DM1) and these present conflicting results. The aim of the study is to evaluate the presence of Anti-TPO in DM1 pregnant women and whether these are related with differences in thyroid function, metabolic control and pregnancy outcome.

Methods: In 78 DM1 women with singleton pregnancies Anti-TPO, Anti-Tg, TSH, FT4I (T4/TBC) were measured each trimester. At each visit (every 1–2 weeks) blood glucose, HbA1c, BMI, units of insulin/kg were recorded, as were complications and pregnancy outcome.

Results: 27/78 women (34.6%) presented with positive Anti-TPO Abs. Clinical data of Anti-TPO positive and negative women are as shown in the table.

First trimester TSH levels were statistically different between the two groups.

There were no differences in the prevalence of diabetic complications, gestational hypertension-preclampsia, abortions or preterm deliveries.

Conclusion: One third of DM1 pregnant women presented with positive Anti-TPO Abs. However their presence is not related with worse metabolic control or adverse pregnancy outcome. It seems that early treatment of thyroid dysfunction and stricter metabolic control a plays more important role than the presence of thyroid antibodies with regard to the pregnancy outcome.

Table 1
	Anti-TPO positive (n=21)	Anti-TPO negative (n=57)
	x±S.D.	x±S.D.	P
Age(years)	29.1±4.5	28.8±4.9	NS
Duration(years)	11.2±8.2	11.6±7.7	NS
BMI(kg/m²)	23.7±0.9	23.9±2.9	NS
TSH 1^st trimester(μIU/ml)	2.4±1.6	1.3±1.0	0.005
TSH 2^nd trimester(μIU/ml)	2.5±1.8	1.7±1.1	0.0058
TSH 3^rd trimester(μIU/ml)	1.5±0.8	1.7±0.9	NS
FT4I 1^st trimester	95.0±12.7	101.2±20.8	NS
FT4I 2^nd trimester	112.6±24.5	110.3±24.1	NS
FT4I 3^rd trimester	106.1±14.4	105.1±18.1	NS
HbA1c 1st trimester(%)	6.5±1.2	6.5±1.7	NS
HbA1c 2nd trimester(%)	5.3±0.9	5.4±0.9	NS
HbA1c 3rd trimester(%)	5.2±0.8	5.2±0.6	NS
Ins 1^st trimester(IU/kg)	0.7±0.3	0.7±0.2	NS
Ins 2^nd trimester(IU/kg)	0.9±0.5	0.8±0.3	NS
Ins 3^rd trimester(IU/kg)	1.1±0.7	1.0±0.4	NS
Birth weight(g)	3215.0±408.3	3092.3±688.0	NS

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Endocrine Abstracts

P555