{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:24:52Z","timestamp":1787063092362,"version":"build-2736575974"},"reference-count":59,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thyroid autoimmunity has been associated with pregnancy loss. Suggested mechanisms include thyroid function aberrations or an underlying breach of immunotolerance. We hypothesized that thyroid autoimmunity is a marker of the latter in women with recurrent pregnancy loss. This study investigated thyroid peroxidase antibody (TPOAb) status as a predictor of live birth in women with unexplained recurrent pregnancy loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Cohort study of 825 consecutive women with recurrent pregnancy loss followed at the tertiary referral center for Recurrent Pregnancy Loss, Copenhagen University Hospital (Rigshospitalet), from 2011 to 2017. Recurrent pregnancy loss was defined as \u22653 consecutive losses, and as unexplained by absence of antiphospholipid syndrome, parental chromosome abnormality, or uterus malformation. Upon first visit, all women were screened for thyrotropin (TSH) and TPOAbs (TPOAb positivity: \u226560 kIU\/L). Adjusted logistic regression analyses included as covariates the following: maternal age, TSH, previous number of losses, body mass index, smoking, pregnancy achieved by assisted reproductive technology, and thyroxine replacement (T4) treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We included 825 women with a total of 3246 previous losses, of whom 139 (16.8%) were TPOAb positive. TPOAb positivity was not associated with the previous number of losses (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.41). Women with unexplained recurrent pregnancy loss had a live birth rate in the first pregnancy after referral of 62.8% (285 of 454). TPOAb positivity was found in 78 of 454 (17.2%) women and was associated with a reduced live birth rate (51.3% vs. 65.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02, adjusted odds ratio [aOR] 0.2 [0.1\u20130.6]\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001). Treatment with T4 increased live birth rate significantly (aOR 3.7 [1.4\u20139.8],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.007), and TPOAb-positive women receiving T4 had a live birth rate similar to that of TPOAb-negative women not receiving T4 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.70). Only 30% of TPOAb-positive women and 39% of women treated with T4 during pregnancy had known thyroid disease at referral.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In a large cohort of women with unexplained recurrent pregnancy loss, TPOAb positivity was predictive of a reduced live birth rate. However, T4 treatment improved odds of live birth. The study supports screening for TPOAbs as a risk factor in women with unexplained recurrent pregnancy loss. The beneficial effect of T4 treatment in this high-risk group needs confirmation by randomized controlled trials. Close collaboration between fertility experts and endocrinologists is paramount.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2019.0077","type":"journal-article","created":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T06:45:11Z","timestamp":1565678711000},"page":"1465-1474","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":60,"title":["Thyroid Peroxidase Antibodies and Prospective Live Birth Rate: A Cohort Study of Women with Recurrent Pregnancy Loss"],"prefix":"10.1177","volume":"29","author":[{"given":"Sofie","family":"Bliddal","sequence":"first","affiliation":[{"name":"Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla","family":"Feldt-Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5se Krogh","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid Marie","family":"Kolte","sequence":"additional","affiliation":[{"name":"Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda Marie","family":"Hilsted","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole Bjarne","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."},{"name":"Department of Gynecology and Obstetrics, Aalborg University Hospital, Aalborg, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus Henrik","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette Svarre","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Recurrent Pregnancy Loss Unit, Fertility Clinic 4071, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,10,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/8.4.333"},{"key":"e_1_3_4_3_2","doi-asserted-by":"crossref","unstructured":"ESHRE Early Pregnancy Guideline Development Group 2018 Recurrent pregnancy loss\u2014guideline of the European Society of Human Reproduction and Embryology. Available at https:\/\/www eshre eu\/Guidelines-and-Legal\/Guidelines\/Recurrent-pregnancy-loss aspx 1-154 (accessed July1 2019).","DOI":"10.1093\/hropen\/hoy004"},{"key":"e_1_3_4_4_2","first-page":"76","article-title":"Recurrent pregnancy loss: etiology, diagnosis, and therapy","volume":"2","author":"Ford HB","year":"2009","unstructured":"Ford HB, , Schust DJ. 2009. Recurrent pregnancy loss: etiology, diagnosis, and therapy. Rev Obstet Gynecol, 2:76\u201383.","journal-title":"Rev Obstet Gynecol"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2012.08.029"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dev014"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-018-4868-4"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.01.166"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0457"},{"key":"e_1_3_4_10_2","first-page":"1","volume-title":"Thyroid International","author":"Bliddal S","year":"2014","unstructured":"Bliddal S, , Feldt-Rasmussen U. 2014. TPOAbs as a risk factor in pregnancy. In: Smyth P (ed) Thyroid International. Merck KGgA, Darmstadt, Germany, 3:1\u201320."},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0358"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04008.x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d2616"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03450110068029"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmr024"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmw019"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1049"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.03.011"},{"key":"e_1_3_4_19_2","first-page":"197","article-title":"Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders","volume":"79","author":"Glinoer D","year":"1994","unstructured":"Glinoer D, , Riahi M, , Grun JP, , Kinthaert J. 1994. Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J Clin Endocrinol Metab, 79:197\u2013204.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0628"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0141"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0087"},{"key":"e_1_3_4_23_2","unstructured":"Juul AB Pildal J Hamid YH Nygaard B Bliddal S Lousen T Carle A Pedersen KB Riis ALD Pedersen IB Nielsen HS Boas M Feldt-Rasmussen U. 2018. National treatment guideline: Thyroid disease in pregnancy and infertility [National Behandlingsvejledning: Thyroideasygdom ved graviditet og infertilitet]. The Danish Endocrine Society. Available at http:\/\/www.endocrinology.dk\/index.php\/2-thyroidea-sygdomme\/5-thyroideasygdom-ved-graviditet-og-infertiliet (accessed July1 2019)."},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2015.08.005"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.7.1637"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2018.05.14"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2018.289348"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.repbio.2018.11.002"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31823c0413"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2011.11.014"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/182472"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/der301"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12561"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/tan.12737"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(98)00509-3"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(12)90830-3"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.2011.01021.x"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)00283-4"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.2004.00215.x"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.11535.1"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0987"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmu028"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1038\/ncpendmet0424"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-71-2-276"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2016.09.002"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0429"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1159\/000184234"},{"key":"e_1_3_4_48_2","first-page":"117","article-title":"Effects of thyroid hormones on the lymphocyte phenotypes in rats: changes in lymphocyte subsets related to thyroid function","volume":"28","author":"Ohashi H","year":"1994","unstructured":"Ohashi H, , Itoh M. 1994. Effects of thyroid hormones on the lymphocyte phenotypes in rats: changes in lymphocyte subsets related to thyroid function. Endocr Regul, 28:117\u2013123.","journal-title":"Endocr Regul"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.157.8.3334"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz003"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1603"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-1803"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh843"},{"key":"e_1_3_4_54_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.18249"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dms052"},{"key":"e_1_3_4_56_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13044-018-0052-y"},{"key":"e_1_3_4_57_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.8755-8920.2000.430404.x"},{"key":"e_1_3_4_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.04.025"},{"key":"e_1_3_4_59_2","doi-asserted-by":"publisher","DOI":"10.1530\/EC-13-0012"},{"key":"e_1_3_4_60_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812537"}],"container-title":["Thyroid\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/thy.2019.0077","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2019.0077","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/thy.2019.0077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:05:54Z","timestamp":1777586754000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/thy.2019.0077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":59,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1089\/thy.2019.0077"],"URL":"https:\/\/doi.org\/10.1089\/thy.2019.0077","relation":{},"ISSN":["1050-7256","1557-9077"],"issn-type":[{"value":"1050-7256","type":"print"},{"value":"1557-9077","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}