الاجسام المضادة للغدة الدرقية لدى المراة الفلسطينية التي تعاني من الاجهاض المتكرر في قطاع غزة

Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown. Autoimmunity has been directly associated in the etiology of several reproductive conditions including unexplained infertility and recurrent pregnancy loss. This study focused on anti-thyroid autoantibodies and thyroid hormones as immunological and hormonal causative factors for RPL. Because the human fetal thyroid does not secrete thyroid hormones until approximately 16 weeks of gestation, the fetus is dependent until that time on a supply from the maternal circulation. The presence of thyroid autoantibodies among pregnant women may create very low thyroid hormones level which may be associated withan increased risk of miscarriages. Aim: To investigate the relationship between anti-thyroid autoantibodies (TG-abs and TPO-abs) and recurrent pregnancy loss among women inGaza strip, and to characterize thyroid hormones level in these spontaneous recurrent aborter women. Methods: The study was case control study where two hundred women 18-30 years old who reside inGaza strip were examined: 100 healthy non pregnant women with history of RPL during the first trimester as cases , and 100 healthy multigravida without any pervious abortion as a control group. For all women in the two groups serum concentration for anti TG-abs, TPO-abs, thyroid stimulating hormone (TSH) and free thyroxine hormone (FT4) were measured using ELISA and MEIA. Results: There was a statistically significant relation between recurrent pregnancy loss and anti TPO autoantibodies (X2= 10.039, P= 0.002), where the majority of positive results were in cases as follow: 23.0% of cases were positive for TPO antibodies compared to 7.0% of control group. Also there was a statistically significant relation between recurrent pregnancy loss and anti TG autoantibodies (X2= 11.317, P= 0.001), where the majority of positive results were in cases as follow: 21% of cases were positive for TG antibodies compared to 5% of control group. The results showed statistically significant relationship between anti-TPO Abs and anti-TG Abs with TSH level (X2=9.968, P=0.002, and X2=5.977, P= 0.034, respectively). Free T4 levels were normal in the two groups. On other hand, there was no statistically significant relationship between thyroid antibodies and Toxoplasma, Cardiolipin and CMV antibodies among women in Gaza Strip. Conclusion: Recurrent pregnancy loss has a statistically significant relation with anti-thyroid autoantibodies (TG-abs and TPO-abs), where 32% of cases were positive for one or both (anti TPO antibodies and/or anti TG antibodies), while the positivity in control where 9.0%