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The Influence of Selenium Supplementation on Postpartum Thyroid Status in Pregnant Women with Thyroid Peroxidase Autoantibodies

Department of Endocrinology (R.N., G.G.), Azienda Ospedaliera LE/1, P.O. "V. Fazzi," 73100 Lecce, Italy; Department of Obstetrics and Gynecology (T.M.), Casa di Cura "Salus," 72100 Brindisi, Italy; Department of Internal Medicine (A.P.), Ospedali Riuniti, 43100 Parma, Italy; Department of Internal Medicine (D.D.), Azienda Ospedaliera PR, "Vaio" Hospital, 43036 Fidenza, Italy; and Endocrine Unit (H.H.), Raja Isteri Pengtran Anak Saleha Hospital, Bandar Seri Begawan BA 1000, Brunei

Address all correspondence and requests for reprints to: Roberto Negro, Department of Endocrinology, Azienda Ospedaliera LE/1, P.O. "V. Fazzi," Piazza F. Muratore, 73100 Lecce, Italy. E-mail: robnegro{at}tiscali.it.

Context: Pregnant women who are positive for thyroid peroxidase antibodies [TPOAb(+)] are prone to develop postpartum thyroid dysfunction (PPTD) and permanent hypothyroidism. Selenium (Se) decreases thyroid inflammatory activity in patients with autoimmune thyroiditis.

Objective: We examined whether Se supplementation, during and after pregnancy, influences the thyroidal autoimmune pattern and function.

Design: This was a prospective, randomized, placebo-controlled study.

Setting: The study was conducted in the Department of Obstetrics and Gynecology and Department of Endocrinology.

Patients: A total of 2143 euthyroid pregnant women participated in the study; 7.9% were TPOAb(+).

Interventions: During pregnancy and the postpartum period, 77 TPOAb(+) women received selenomethionine 200 µg/d (group S1), 74 TPOAb(+) women received placebo (group S0), and 81 TPOAb(–) age-matched women were the control group (group C).

Main Outcome Measures: We measured the prevalence of PPTD and hypothyroidism.

Results: PPTD and permanent hypothyroidism were significantly lower in group S1 compared with S0 (28.6 vs. 48.6%, P < 0.01; and 11.7 vs. 20.3%, P < 0.01).

Conclusion: Se supplementation during pregnancy and in the postpartum period reduced thyroid inflammatory activity and the incidence of hypothyroidism.

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