Association of thyroid autoimmunity and pregnancy outcomes in unexplained recurrent pregnancy loss women: a prospective cohort study

作者：Ruifang Wang, Ling Liu, Wei Zhang, Jian Zhang, Kexin Wang, Fang Wang · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1711369 · 被引用次数：2 · 研究领域：Thyroid Disorders and Treatments、Pregnancy and preeclampsia studies、Ophthalmology and Eye Disorders

Background: Unexplained recurrent pregnancy loss (URPL) and thyroid autoimmunity (TAI) have received considerable attention. However, the association between TAI and subsequent infertility or pregnancy outcomes among euthyroid women with URPL remains unclear. This study aimed to clarify these relationships. Methods: From September 2019 to December 2022, we prospectively enrolled women with URPL at the Lanzhou University Second Hospital and collected pre-pregnancy and first-trimester data. Participants were divided into two groups: TAI and non-TAI, based on their thyroid antibody status. Changes in thyroid function parameters from pre-pregnancy to the first trimester were compared between the two groups. We assessed the incidence of infertility, subsequent pregnancy loss, and pregnancy complications. Logistic regression analysis was performed to examine the associations between TAI and infertility, subsequent pregnancy loss, and adverse pregnancy outcomes, after adjusting for maternal age, body mass index, gravidity, number of pregnancy losses, and concentrations of thyroid-stimulating hormone (TSH) and free thyroxine (fT4). Results: Of the 576 euthyroid women with URPL included, 101 (17.5%) were classified as TAI, and 475 (82.5%) as non-TAI. Subsequently, 110 (19.1%) patients were diagnosed with infertility and 466 (80.9%) patients conceived. The mean TSH concentrations in the TAI group were higher than those in the non-TAI group both pre-pregnancy (2.3 ± 0.8 vs. 2.2 ± 0.9 mI...