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Alex Stagnaro-Green, MD; Sheila H. Roman, MD; Rhoda H. Cobin, MD; Essam El-Harazy, MD; Michael Alvarez-Marfany, MD; Terry F. Davies, MD, FRCP

JAMA. 1990;264(11):1422-1425.

Abstract
We screened 552 women who presented to their obstetrician in the first trimester of pregnancy using highly sensitive enzyme-linked immunosorbent assays for the presence of thyroglobulin and thyroidperoxidase autoantibodies and found an incidence of positivity of 19.6%. The tendency to secrete detectable levels of thyroid autoantibodies was significantly correlated with an increased rate of miscarriage. Thyroid autoantibody—positive women miscarried at a rate of 17%, compared with 8.4% for the autoantibody-negative women. Individual levels of thyroglobulin and thyroidperoxidase autoantibodies were similarly related to this increased miscarriage rate, with no evidence of autoantibody specificity in the relationship. Furthermore, the increase in miscarriages could not be explained by differences in thyroid hormone levels, the presence of cardiolipin autoantibodies, maternal age, gestational age at the time of maternal entry into the study, or previous obstetric history. We conclude that thyroid autoantibodies are an independent marker of "at-risk" pregnancy.

(JAMA. 1990;264:1422-1425)

Author Affiliations
From the Division of Endocrinology, Department of Medicine (Drs Stagnaro-Green, Roman, Cobin, ElHarazy, Alvarez-Marfany, and Davies), and the Department of Obstetrics, Gynecology, and Reproductive Science (Dr Davies), Mount Sinai School of Medicine, New York, NY.

Footnotes
Read before the 71st Annual Meeting of the Endocrine Society, Seattle, Wash, June 23,1989.

Reprint requests to Box 1055, Mount Sinai Medical Center, 1 Gustave L Levy PI, New York, NY 10029 (Dr Stagnaro-Green).

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