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A Methodologic Overview of the Literature

Hertzel C. Gerstein, MD, MSc, FRCPC

Arch Intern Med. 1990;150(7):1397-1400.

Abstract
• The incidence of postpartum thyroiditis (PPT) in the general population has been reported to range from 1.9% to 16.7%, depending on the study. To determine whether bias may have played a role in the generation of these widely varying estimates, a set of methodologic criteria were applied to the published original research dealing with the epidemiology of PPT. The articles that passed these methodologic filters reported a narrow range of incidences of PPT, varying between 3.7% and 5.9%. Reanalysis of these articles confirmed that thyrotoxicosis occurred more frequently in the first 3 months post partum than did hypothyroidism, and that a positive antimicrosomal antibody titer was strongly associated with postpartum thyroid dysfunction (odds ratio, 86.6; 95% confidence interval, 45.9 to 163.2). This article suggests that PPT is a common condition that occurs in the postpartum period. The best estimate of the incidence of PPT in an unselected cohort of postpartum women is 4.9%.

(Arch Intern Med. 1990;150:1397-1400)

Author Affiliations
From the Division of Endocrinology and Metabolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Footnotes
Accepted for publication February 7,1990.

Reprint requests to the McMaster Medical Clinics, 3rd Floor, Henderson General Hospital, 711 Concession St, Hamilton, Ontario, Canada L8V1C3 (Dr Gerstein).

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