Preconceptual thyroid peroxidase antibody positivity in women with recurrent pregnancy losses may contribute to an increased risk for another miscarriage
Authors' conclusion
In women with at least three recurrent unexplained pregnancy losses, the presence of TPO-ab may contribute to an increased risk of a first-trimester miscarriage, possibly more pronounced in very early pregnancy. TSH levels 2.5-4.0 mU/L do not seem to increase the miscarriage risk.
Study context
- Population
- Women with at least three unexplained recurrent first-trimester miscarriages investigated at a Swedish secondary referral center
- Participants
- 483 women
- Comparison
- Women with vs without preconceptual thyroid peroxidase antibody (TPO-ab)
- Primary endpoint
- New first-trimester miscarriage
Methodological detailssingle referral centre, Acetylsalicylic acid did not affect the risk of a new miscarriage in the parent randomized trial
- Single referral centre
- Acetylsalicylic acid did not affect the risk of a new miscarriage in the parent randomized trial
Primary result
As reported in the abstract
All first-trimester miscarriages
TPO-ab positive vs TPO-ab negativeEstimate (95% CI)
All first-trimester miscarriages
OR 1.60(0.99–2.57)
Adjusted for age, number of previous miscarriages, obesity, TSH
adjusted OR 1.54(0.94–2.53)
Further findings
| Outcome | TPO-ab positive | TPO-ab negative | Estimate | |
|---|---|---|---|---|
| Very early (biochemical) pregnancy losses | 6.8% | 2.0% | OR 3.51 (95% CI 1.15–10.71) | |
| Very early (biochemical) pregnancy losses | adjusted OR 2.91 (95% CI 0.91–9.29) | |||
| 0.050.21520Ratio (log scale) |
New miscarriage by thyroid stimulating hormone (TSH) in upper range of normal
- No association between TSH in upper range of normal and new miscarriage, adjusted OR
- 0.76 (95% CI; 0.32-1.83)
Prediction model for a new miscarriage
- Model included number of previous miscarriages, woman's age and presence of TPO-ab
Original publication
Preconceptual thyroid peroxidase antibody positivity in women with recurrent pregnancy losses may contribute to an increased risk for another miscarriage. Clin Endocrinol (Oxf). Published 25 October 2022. doi:10.
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