Effect of gestational subclinical hypothyroidism combined with TPOAb positivity on the risk of preeclampsia

Gao Yang; Irina; Kou Xinhong; Wei Dongqin; Geng Ruijie; Lin Yuting; Wang Haixia; Zhu Qiuju

doi:10.11986/j.issn.1673-873X.2025.10.21

Abstract：Objective To investigate the effect of gestational subclinical hypothyroidism(SCH)combined with thyroid peroxi-dase antibody(TPOAb)positivity on the risk of preeclampsia,so as to provide a reference for clinical practice.Methods Pregnant women who received prenatal care and delivered at Urumqi Maternal and Child Health Hospital were grouped as fol-lows:155 women with normal thyroid function and negative TPOAb were enrolled as the normal control group;155 women with normal thyroid function but positive TPOAb were enrolled as the isolated TPOAb-positive group;155 women diagnosed with SCH were enrolled as the SCH group,which was further divided by TPOAb status into SCH+TPOAb-positive(n=69)and SCH+TPOAb-negative(n=86).The incidence of preeclampsia,adverse pregnancy outcomes,and adverse neonatal out-comes were compared among the four groups.Results The incidence of preeclampsia in the SCH+TPOAb-positive group was 27.54%,which was significantly higher than that in the SCH+TPOAb-negative group(12.79%),the isolated TPOAb-posi-tive group(9.68%),and the normal control group(4.52%;P<0.05).The SCH+TPOAb-negative group also had a signifi-cantly higher incidence of preeclampsia than the normal control group(P<0.05),while the difference in incidence of pre-eclampsia between the isolated TPOAb-positive group and the normal control group was not statistically significant(P>0.05).The SCH+TPOAb-positive group had significantly higher rates of preterm birth,placental abruption,and fetal intrau-terine distress than both the isolated TPOAb-positive group and the normal control group(P<0.05).The incidence of low-birth-weight infants in the SCH+TPOAb-positive group was 15.94%,which was significantly higher than 4.52%in the isola-ted TPOAb-positive group and 3.23%in the normal control group(P<0.05).Conclusion Gestational SCH combined with TPOAb positivity significantly increases the risk of preeclampsia and the incidence of adverse pregnancy outcomes.Clinical practice should strengthen combined screening of thyroid function and TPOAb in pregnant women,and provide early interven-tion and close monitoring for high-risk individuals to improve maternal and neonatal outcomes.