Connective tissue diseases and autoimmune thyroid disorders in the first trimester of pregnancy

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Objective: To investigate the rates and coexistence of autoimmune thyroid and connective tissue diseases (CTD) during the first trimester of pregnancy and their influence on pregnancy outcome. Study design: A cohort study of 150 women with CTD diagnosed during first trimester of pregnancy and 150 negative controls. Main outcome measures: Screening of CTD by a self-reported questionnaire, rheumatic and thyroid autoantibody detection, clinical rheumatological evaluation and obstetric outcomes. Results: Out of 3852 women screened, 61 (1.6%) were diagnosed with undefined connective tissue disease (UCTD), 28 (0.7%) with major CTD (six rheumatoid arthritis, five systemic lupus erythematosus, eight Sjogren syndrome, five anti-phospholipid syndrome, two systemic sclerosis, one mixed CTD and one monoarticular arthritis) and 61 (1.6%) had insufficient criteria for a diagnosis of a rheumatic disease. The overall prevalence of either thyroid peroxidase (TPO-a) or thyroglobulin (TG-a) autoantibodies detection was 8% (12/150) among controls, 62.3% (38/61) among UCTD and 60.7% (17/28) in women with a major CTD (p <.001 compared to controls for both comparisons). After adjustment for confounders, overall CTDs (major or undefined) (OR = 3.54, 95% CI; 1.61-7.78) and TPO-a plus TG-a positivity (OR = 2.78, 95% CI;1.29-5.98) were independently associated with increased risks of moderate-severe complications of pregnancy (miscarriage, fetal growth restriction, preeclampsia, delivery before 34 weeks). Conclusions: Rheumatic and thyroid autoantibodies during pregnancy are closely associated. Thyroid antibodies could add to the risk of adverse pregnancy outcome associated with connective tissue diseases.

Original languageEnglish
Pages (from-to)32-37
Number of pages6
JournalJournal of Reproductive Immunology
Publication statusPublished - Apr 1 2016


  • Pregnancy
  • Rheumatic diseases
  • Thyroid autoantibody

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Obstetrics and Gynaecology
  • Reproductive Medicine


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