Thyroid problems in pregnancy

If you are a woman with MS and want to fall pregnant you need to be aware of the potential to develop thyroid problems during pregnancy. #MSBlog #MSResearch

Epub: Jalkanen et al. Increased thyroid autoimmunity among women with multiple sclerosis in the postpartum setting. Mult Scler. 2013 Apr.

BACKGROUND: MSers are predisposed to thyroid abnormalities, but the risk for pregnancy-related thyroid pathology among MSers has not been evaluated.

OBJECTIVES: The objectives of this research are to prospectively evaluate the prevalence of thyroid autoimmunity among MSers in relation to pregnancy, and to investigate its impact on pregnancy outcome, postpartum depression and fatigue.

METHODS: Forty-six pregnant MSers underwent repeat testing for serum thyroid antibodies (Abs), clinical evaluation and thyroid hormone measurement. Results were compared to 35 age-matched healthy mothers.

RESULTS: At six months postpartum 35.3% of MSers presented elevated levels of thyroid Abs compared to 5.7% of controls, p = 0.01. Mean thyroid Ab concentrations among MSers were significantly reduced during pregnancy and returned to maximal levels at six months postpartum. The proportion of individuals with postpartum thyroid dysfunction did not differ significantly between MSers and healthy controls (3.4% vs 2.9%, p = 1.00). Elevated thyroid Ab levels did not increase the risk for adverse pregnancy outcome, fatigue or postpartum depression.

CONCLUSIONS: Considering the tendency of MS mothers to develop thyroid autoimmunity postpartum and in association to treatments, we recommend screening MSers for thyroid dysfunction (TSH) during early pregnancy and after delivery.

“There is an association between MS and autoimmune thyroid disease. It seems that pregnancy swings the pendulum in favor of developing thyroid auto-antibodies  This is similar to what happens post-alemtuzumab treatment. I wonder if there is a relationship between the two observations?

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Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

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