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Association between previously unknown connective tissue disease and subclinical hypothyroidism diagnosed during first trimester of pregnancy.
Beneventi, Fausta; Locatelli, Elena; Alpini, Claudia; Lovati, Elisabetta; Ramoni, Véronique; Simonetta, Margherita; Cavagnoli, Chiara; Spinillo, Arsenio.
Afiliación
  • Beneventi F; Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy.
  • Locatelli E; Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy. Electronic address: elena.loc@libero.it.
  • Alpini C; Clinical Chemistry Laboratory, IRCCS Foundation Policlinico San Matteo, Pavia, Italy.
  • Lovati E; First Department of Medicine, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia, Italy.
  • Ramoni V; Division of Rheumatology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy.
  • Simonetta M; Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy.
  • Cavagnoli C; Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy.
  • Spinillo A; Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy.
Fertil Steril ; 104(5): 1195-201, 2015 Nov.
Article en En | MEDLINE | ID: mdl-26297901
OBJECTIVE: To investigate the presence of autoimmune rheumatic disorders among women with autoimmune thyroid disorders diagnosed during the first trimester of pregnancy and subsequent pregnancy outcomes. DESIGN: Case-control study. SETTING: Tertiary obstetric and gynecologic center. PATIENT(S): Pregnant women in the first trimester of pregnancy. INTERVENTION(S): Clinical, laboratory, ultrasonographic evaluations. MAIN OUTCOME MEASURE(S): Thyroid-stimulating hormone (TSH) level; antibodies against thyroperoxidase, thyroid globulin and TSH receptor detection; screening for rheumatic symptoms and antinuclear antibodies (ANA); uterine artery pulsatility index evaluation; pregnancy complication onset. RESULT(S): Out of 3,450 women enrolled, 106 (3%) were diagnosed with autoimmune thyroid disorders. ANA were present in 18 (16.9%) of 106 cases and 26 (12.6%) of 206 controls. Of the cases, 28 (26.4%) of 106 reported rheumatic symptoms, 5 of these were diagnosed with Sjögren syndrome or with undefined connective tissue disease. Autoimmune thyroid diseases are statistically significantly associated with a higher risk of preeclampsia, fetal growth restriction, and overall pregnancy complications compared with controls, with a higher uterine artery pulsatility index, suggesting a defective placentation in thyroid disorders. The effect of ANA-positivity on moderate/severe adverse pregnancy outcomes was statistically significant among the patients with thyroid disorders (9 of 18 as compared to 8 of 88, odds ratio 9.65; 95% confidence interval, 2.613-7.81). CONCLUSION(S): Connective tissue diseases are frequently associated with autoimmune thyroid disorders diagnosed during the first trimester of pregnancy. Thyroid autoimmunity and ANA positivity independently increased the risk of adverse pregnancy outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones del Embarazo / Primer Trimestre del Embarazo / Enfermedades Autoinmunes / Enfermedades del Tejido Conjuntivo / Hipotiroidismo Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Fertil Steril Año: 2015 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones del Embarazo / Primer Trimestre del Embarazo / Enfermedades Autoinmunes / Enfermedades del Tejido Conjuntivo / Hipotiroidismo Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Fertil Steril Año: 2015 Tipo del documento: Article País de afiliación: Italia
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