Increased thyroid autoimmunity among women with MS in the postpartum setting

The purpose of this study was to evaluate the prevalence of thyroid autoimmunity among MS patients in relation to pregnancy, and to look at its impact on pregnancy outcome, postpartum depression and fatigue.

46 pregnant women with MS underwent repeat testing for serum thyroid antibodies (Abs), clinical evaluation and thyroid hormone measurement and the results were compared to 35 age-matched healthy mothers. They found that six months post-partum, 35.3% of patients had increased levels of thyroid Abs compared to 5.7% of controls. In the women with MS, the mean thyroid Ab concentrations were significantly reduced during pregnancy and returned to maximal levels at 6 months postpartum. One potential hypothesis for the pregnancy-related improvement of MS and autoimmune thyroid disease may be explained by regulatory T cell expansion during pregnancy.

They found that women with MS are more prone to develop thyroid autoimmunity in the postpartum period, which is likely due to generalised increased immune activation post delivery. There was no increased risk of adverse pregnancy outcomes-fatigue or postpartum depression with elevated thyroid Ab levels.

In conclusion the researchers suggest screening MS patients for thyroid dysfunction (TSH) during early pregnancy and 3 months after delivery.

 
Authors: Jalkanen A, Saraste M, Gfeller A

Source: Mult Scler. 2013 Apr 29. [Epub ahead of print]

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