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Journal of Thyroid Research
Volume 2011 (2011), Article ID 745135, 5 pages
Review Article

Thyroid Peroxidase Antibody and Screening for Postpartum Thyroid Dysfunction

1Section of Endocrinology and Diabetes, Department of Medicine, Caerphilly District Miners Hospital, St. Martin's Road, Caerphilly CF83 2WW, UK
2C2 Link, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK

Received 14 March 2011; Accepted 10 May 2011

Academic Editor: Kris Gustave Poppe

Copyright © 2011 Mohamed A. Adlan and Lakdasa D. Premawardhana. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Postpartum thyroid dysfunction (PPTD) is a common disorder which causes considerable morbidity in affected women. The availability of effective treatment for hypothyroid PPTD, the occurrence of the disease in subsequent pregnancies and the need to identify subjects who develop long term hypothyroidism, has prompted discussion about screening for this disorder. There is currently no consensus about screening as investigations hitherto have been variable in their design, definitions and assay frequency and methodology. There is also a lack of consensus about a suitable screening tool although thyroid peroxidase antibody (TPOAb) is a leading contender. We present data about the use of TPOAb in early pregnancy and its value as a screening tool. Although its positive predictive value is moderate, its sensitivity and specificity when used in early pregnancy are comparable or better compared to other times during pregnancy and the postpartum period. Recent studies have also confirmed this strategy to be cost effective and to compare favourably with other screening strategies. We also explore the advantages of universal screening.