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.
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.