{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T17:44:43Z","timestamp":1773078283119,"version":"3.50.1"},"reference-count":0,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2002,4,5]],"date-time":"2002-04-05T00:00:00Z","timestamp":1017964800000},"content-version":"vor","delay-in-days":643,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2000,7]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Postpartum thyroid dysfunction (PPTD) is an autoimmune disorder characterized by the development of transient hyperthyroidism and, more frequently, hypothyroidism (or both) during the first six months of the puerperal period. A variable incidence has been reported in part because of differences in the number of women studied, the frequency of thyroid assessment postpartum, diagnostic criteria and methodology. The aim of this study was to evaluate thyroid function, ultrasound images and titre of autoantibodies against thyroid antigens in a cohort of pregnant women who met the criteria of \u2018normal\u2019 thyroid gland structure on clinical examination and imaging and normal thyroid function tests without a significantly positive anti\u2010thyroid peroxidase (TPO) antibody titre (i.e. &lt;\u2003100\u2003U\/ml) in the first trimester.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN AND PATIENTS<\/jats:title><jats:p>Eight hundred nulliparous or multiparous (one to seven previous pregnancies) pregnant women (age 26.1\u2003\u00b1\u20034.8 years, mean \u00b1\u2003SD), were submitted to clinical, laboratory and ultrasonographic examination in the first trimester of pregnancy. Among these forty\u2010six patients were excluded because of thyroid dysfunction, ultrasound structural abnormalities or a positive anti\u2010TPO antibody titre (&gt;\u2003100\u2003U\/ml). A total number of 754 women were available for further studies in the postpartum period. A relatively large number of these patients (386) were lost for follow\u2010up either before or after delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>MEASUREMENTS<\/jats:title><jats:p>A cohort of 368 puerperal women was followed up regularly at 3, 6, 12 and 24 months after delivery, with periodic thyroid function tests, random urine iodine measurements, assays for serum autoantibodies against thyroid antigens and imaging by ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The provisional diagnosis of PPTD was established in 78 out of 368 who had positive anti\u2010TPO levels and ultrasonographic thyroid structural changes. Twenty\u2010nine of these patients had a transient rise of anti\u2010TPO autoantibodies characterizing an autoimmune reaction. These autoantibodies levels progressively declined or became negative. Moreover none of these patients had evidence for altered thyroid function during the 18\u201324 months of follow\u2010up. The remaining 49 patients (13.3%) progressively developed thyroid function abnormalities (mainly hypothyroidism) indicating the presence of thyroid gland changes due to PPTD. Further follow\u2010up studies indicated that at 18\u201324 months, 42 patients had serum levels of anti\u2010TPO\u2010Ab that were more elevated, as compared with the first year values. Predictive factors found during pregnancy for developing PPTD were: (1) relatively low levels of anti\u2010TPO, between 60 and 100\u2003U\/ml (odds ratio 3.1\u2003:\u20031), and (2) ultrasonographic thyroid structural changes in the first trimester (odds ratio 6.4\u2003:\u20031).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>We conclude that the prevalence of postpartum thyroid dysfunction in our geographical area ranges from 6.7% to 13.3%, considering, respectively, all pregnant women that were examined (<jats:italic>n<\/jats:italic>\u2003=\u2003754) or only the number of puerperal women actually followed\u2010up (<jats:italic>n<\/jats:italic>\u2003=\u2003368). A transient form of thyroid autoimmune reaction characterized by elevated serum levels of anti\u2010TPO that progressively declined or disappeared was observed in 29 puerperal women. Sonographic structural and echogenicity changes in the thyroid gland and borderline positive anti\u2010TPO levels (between 60 and 100\u2003U\/ml) during pregnancy were considered to be of predictive value for development of postpartum thyroid dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1046\/j.1365-2265.2000.01034.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T10:45:40Z","timestamp":1047379540000},"page":"21-31","source":"Crossref","is-referenced-by-count":28,"title":["Prevalence and characteristics of postpartum thyroid dysfunction in S\u00e3o Paulo, Brazil"],"prefix":"10.1111","volume":"53","author":[{"given":"Maria Fernanda","family":"Barca","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meyer","family":"Knobel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Tomimori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Silvia","family":"Cardia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldo","family":"Medeiros\u2010Neto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,4,5]]},"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1365-2265.2000.01034.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1365-2265.2000.01034.x","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1046\/j.1365-2265.2000.01034.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T11:24:49Z","timestamp":1698578689000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1046\/j.1365-2265.2000.01034.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,7]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2000,7]]}},"alternative-id":["10.1046\/j.1365-2265.2000.01034.x"],"URL":"https:\/\/doi.org\/10.1046\/j.1365-2265.2000.01034.x","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,7]]}}}