• MCM

1 hour

All audiences

Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence

The purpose of this activity is to review the evidence for the association between thyroid autoantibodies and miscarriage and preterm birth in women with normal thyroid function, and to examine the effect of treatment with levothyroxine on pregnancy outcomes in this group of women.

Learning outcomes

1) Appraise the strength of association between the presence of thyroid autoantibodies in pregnant women with normal thyroid function and adverse pregnancy outcomes such as miscarriage and preterm births;

2) Discuss the influence of maternal age and serum concentrations of thyroid stimulating hormone on these associations;

3) Recognise the effect of levothyroxine treatment on adverse pregnancy outcomes in this group of women.

Written by:

BMJ and the Cleveland Clinic

BMJ and the Cleveland Clinic

Authors/Faculty:

Shakila Thangaratinam, Alex Tan, Ellen Knox, Mark D Kilby, Jayne A Franklyn, and Arri Coomarasamy

Shakila Thangaratinam, Alex Tan, Ellen Knox, Mark D Kilby, Jayne A Franklyn, and Arri Coomarasamy

Biography :

Shakila Thangaratinam is a senior lecturer/consultant in obstetrics and maternal medicine at the Centre for Health Sciences, Queen Mary University of London, UK.

Biography :

Alex Tan is an academic foundation trainee at the School of Clinical and Experimental Medicine, University of Birmingham, UK.

Biography :

Ellen Knox is a consultant obstetrician/subspecialist in fetal medicine at the Fetal Medicine Centre, Birmingham Women’s Foundation Trust, UK.

Biography :

Mark D Kilby is a professor of fetal medicine at the School of Clinical and Experimental Medicine, University of Birmingham, and the Fetal Medicine Centre, Birmingham Women’s Foundation Trust, UK.

Biography :

Jayne Franklyn is a professor of medicine at the School of Clinical and Experimental Medicine, University of Birmingham, UK.

Biography :

Arri Coomarasamy is a clinical reader/consultant gynaecologist and subspecialist in reproductive medicine and surgery at the School of Clinical and Experimental Medicine, University of Birmingham, UK.

Disclosure :

All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. The authors have been funded by the NIHR (National Institute of Health Research, UK) EME Programme (09-100-10) to conduct a multicentre placebo-controlled randomised trial on the pregnancy effects of levothyroxine treatment in thyroid antibody positive women with normal thyroid function (the TABLET trial).

Activity Directors:

William D Carey, MD and Dr Kirsten Patrick

William D Carey, MD and Dr Kirsten Patrick

Biography :

William D Carey, MD is Director, Center for Continuing Education, Cleveland Clinic, Cleveland, Ohio. Dr Kirsten Patrick is an Assistant Editor, British Medical Journal, London.

Disclosure :

We declare no financial interests, commercial affiliations, or conflicts of interest.

CME Disclaimer :

The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by any of the accreditors. In no event will any of the accreditors be liable for any decision made or action taken in reliance upon the information provided through this CME activity.

Last updated

09 May 2011

Release date

09 May 2011

Expiration date

09 May 2012

Accreditation

Accreditor credit Accreditation statement
ASCOFAME 1:00 hour BMJ Learning has assigned 1 hour of CPD/CME credit to this module. BMJ Learning modules are being certified for ASCOFAME VIRTUAL (Colombia).
Australian College of Nursing 1 credit, 1:00 hour ACN 3LP participants can claim 1 CNE point per hour of active learning for modules that are directly related to their area of nursing practice (no limit).
Austrian Academy of Physicians 1 credit, 1:00 hour BMJ Learning modules have been certified for DFT Punkte. DFT Punkte are accepted in Austria
BMJ Learning 1 credit, 1:00 hour BMJ Learning has assigned one hour of credit to the module and related journal article
BMJ Learning 1 credit, 1:00 hour BMJ Learning has assigned one hour of credit to this module
Bahrain Defence Force Hospital 1 credit, 1:00 hour The Bahrain Defence Force Military Hospital represented by the Ministry of Defence Bahrain recognises BMJ Learning as being accredited for the purpose of continuous medical education (CME)/continuous professional development (CPD) in BDF. Healthcare professionals can thus claim continuous professional development credits for their activity in BMJ Learning. Completion of one module is considered the equivalent of one credit or one hour of learning.
Bhutan Medical and Health Council 1 credit, 1:00 hour Bhutan Medical and Health Council has formally accredited all BMJ Learning online modules for continuous professional development. Bhutan Medical and Health Council will accept the CME credit provided by BMJ Learning to any registered members of Bhutan Medical and Health Council for renewal of their registration.
Delhi Medical Council 1 credit, 1:00 hour The Delhi Medical Council recognises BMJ Learning as being accredited for the purpose of continuous medical education (CME)/continuous professional development (CPD). Doctors can thus claim continuous professional development credits for their activity in BMJ Learning. Completion of one module is considered the equivalent of 1 credit or 1 hour of learning.
Dubai Health Authority 1 credit, 1:00 hour BMJ Learning is approved as a CME resource by the Dubai Health Authority (accreditation number 0254/11)
Iraqi Ministry of Health 1 credit, 1:00 hour The Iraq Ministry of Health has accredited BMJ Learning for the purposes of CME. One module is the equivalent of one hour or one credit point.
Kuwait Institute for Medical Specialization 1 credit, 1:00 hour Kuwait Institute for Medical Specialization (KIMS) of the Ministry of Health, State of Kuwait is the authority responsible for organising all aspects of postgraduate training of medical practitioners and other health professionals in Kuwait. Users within Kuwait can claim one hour or one credit per hour of learning completed.
Pakistan Society of Family Physicians 1 credit, 1:00 hour The Pakistan Society of Family Physicians has assigned 1 hour of credit to this module.
Royal Australasian College of Physicians 1:00 hour The RACP does not accredit CPD activities, but MyCPD Program guidelines state that fellows can claim a maximum of 50 credits per year for online learning under 'Category 6 - Other Learning Activities'.
SOGIMIG 1 credit, 1:00 hour This is to state that Associacao de Obstetricia e Ginecologia de Minas Gerais recognises BMJ Learning as being accredited for the purposes of continuing educational development. Healthcare professionals and students can thus claim continuing professional development credits for their activity on BMJ Learning. Completion of one learning module is the equivalent of 1 credits or 1 hour of learning.
The Colleges of Medicine of South Africa 3 credits The Colleges of Medicine of South Africa has accredited this BMJ Learning module (accreditation number: MDB014/254/06/2010)
The Ministry of Public Health in Qatar 1 credit, 1:00 hour The Ministry of Public Health in Qatar represented by the Accreditation Department of the Qatar Council for Health Practitioners recognizes the continuous medical education (CME)/continuing professional development (CPD) modules provided through BMJ Learning as Category II self-directed learning activities in the State of Qatar. Healthcare professionals in Qatar can thus claim continuing professional development credits for their activity on BMJ Learning, calculated as 1 credit unit per 1 hour (Organization Code OP-02).
The Royal New Zealand College of General Practitioners 1 credit, 1:00 hour RNZCGP endorses the British Medical Journal online CME programmes
Trinidad and Tobago Medical Association 0.5 credits, 1:00 hour The Trinidad and Tobago Medical Association has accredited BMJ Learning. One module equates to 0.5 credits.
UAE Ministry of Health and Prevention 1 credit, 1:00 hour This Program has been awarded 1 CPD Credit Hour by the UAE Ministry of Health and Prevention.
University of Health Sciences Lahore 1 credit, 1:00 hour University of Health Sciences Lahore has assigned 1 hour of credit to this module.