Thyrotropin receptor antibody: A novel risk indicator for pregnancy loss.

BACKGROUND: Thyroid autoantibody has been associated with adverse pregnancy outcomes. However, thyroid-receptor antibody (TRAb) has not been considered as a potential risk assessment indicator for adverse pregnancy outcomes. Therefore, we assessed the role of TRAb in evaluation of the risk of adverse pregnancy outcomes.

METHODS: Pregnant women residing in Chongqing were enrolled in the study from 2012 to 2014. The TRAb, thyroid-stimulating hormone (TSH), free thyroxine (FT4 ), and free triiodothyronine (FT3 ) of all patients were analyzed via electrochemiluminescence assays. All data were recorded and analyzed statistically using SPSS.

RESULTS: A total of 468 pregnant women were included in the analysis. TRAb levels were higher in women with adverse pregnancy outcomes than those in women without adverse pregnancy outcomes. The incidence rate of pregnancy loss was significantly higher in the TRAb-positive group than that in the negative group, but this difference was not found in preterm delivery and early preterm delivery. In the logistic regression model, TRAb was an independent risk factor for pregnancy loss, but not for preterm delivery and early preterm delivery. The optimal cutoff point for TRAb was 3.53 IU/L, and the sensitivity and specificity of TRAb to assess the risk of pregnancy loss are 83.5% and 85.3%, respectively. Receiver-operating characteristic (ROC) curves revealed that TRAb was superior to the combination of TSH, FT4 and FT3 as an indicator for assessment.

CONCLUSIONS: TRAb as a more sensitive indicator providing valuable detection to assess the potential risk of pregnancy loss, and it can be used as an effective tool to improve the clinical management of thyroid disease in pregnant women.