The clinical spectrum of postpartum thyroid disease

The clinical and biochemical features of postpartum thyroid disease wereanalysed in 152 antithyroid peroxidase antibody-positive (anti TPO+ve)women and compared with 239 anti-TPO-ve age-matched control postpartumwomen. All were assessed monthly for up to 12 months postpartum. Seventythree anti-TPO+ve women developed post-partum thyroiditis (PPT): 19.2%hyperthyroid alone, 49.3% hypothyroid alone, and 31.5% characterized byhyper- followed by hypothyroidism. None of the antibody-negative womendeveloped any thyroid dysfunction. A significant increase in many of elevensymptoms of hypothyroidism and some of eight symptoms of hyperthyroidismcompared to control women was observed in all anti-TPO+ve women,independent of thyroid status. This was particularly seen in women wholater developed PPT when they were euthyroid, but was also observed ineuthyroid anti-TPO+ve women who showed no decline of thyroid functionduring the postpartum period. Although PPT is usually transient, thiscondition, and the euthyroid antibody-positive state, may be associatedwith significant symptomatology, including an increased incidence of minorto moderate depression. Early recognition of this syndrome by antenatalscreening of thyroid antibodies may contribute to improved management ofwomen during the postpartum period.