Prevalence of hypothyroidism in pregnancy and its feto-maternal outcome
Background: Thyroid disorders are among the most common endocrine disorders in pregnant females. Hypothyroidism is more common during pregnancy than hyperthyroidism. The overall prevalence of subclinical hypothyroidism in general population has been reported to be 4% -8.5% while overt hypothyroidism is 0.2 – 0.3% (2).
Objective: To evaluate the prevalence of hypothyroidism in pregnancy and to determine association of feto-maternal outcome with hypothyroidism.
Material and Methods: A Prospective study conducted over 120 patients who came to routine antenatal care and/or admitted in labour room of Subharti Hospital, Dehradun over a period of 01 year. Women with singleton pregnancy irrespective of the period of gestation were randomly selected for the study. Patients thus selected were divided into two groups: Control Group: This comprised of pregnant females in whom serum TSH and FT4 levels were found to be within normal range on estimation.
Study Group: This group included pregnant females who were diagnosed as cases of subclinical hypothyroidism on the basis of raised TSH and normal TF4 levels and overt hypothyroidism on basis of raised TSH and decreased TF4.
Results: The prevalence of hypothyroidism came out to be 24.29%. Higher rate of still births, hyperbilirubinemia and admission to neonatal ICU (foetal distress, meconium stained liquor) in the hypothyroid group were observed.
Conclusion: Hypothyroidismcontinues to be an important medical condition in pregnancy with significant feto-maternal morbidity. Due to the adverse effect of maternal thyroid disorder on maternal and fetal outcome, timely diagnosis and initiation of treatment of hypothyroid disorders is essential.
2. McLeod D, McIntyre H. Subclinical hypothyroidism and related biochemical entities in pregnancy: implications and management. Obstetric Medicine. 2010;3(4):139-144.
3. Tudosa R, Vartej P, Horhoianu I, Ghica C, Mateescu S, Dumitrache I. Maternal and fetal complications of the hypothyroidism-related pregnancy. Maedica (Buchar). 2010;5(2):116-123.
4. Kumar A, Singh R, Prasad S. Hypothyroidism during pregnancy. International Journal of Gynecology& Obstetrics. 2003;84(3):252-253.
5. Saki F, Dabbaghmanesh M, Ghaemi S, Forouhari S, RanjbarOmrani G, Bakhshayeshkaram M. Thyroid Function in Pregnancy and Its Influences on Maternal and Fetal Outcomes. International Journal of Endocrinology and Metabolism. 2014;12(4).
6. Sahu MT, Das V, Mittal S, et al. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol Obstet. 2010 Feb;281(2):215-20. doi: 10.1007/s00404-009-1105-1. Epub 2009 May 13. [pubmed]
7. Nuzhat A, Pranathi R, Evita F. Hypothyroidism in pregnancy: Is universal screening needed?. J ObstetGynecol India. 2006;56(6):495-498.
8. Kumar A, Ghosh BK, Murthy NS. Maternal thyroid hormonal status in preeclampsia. Indian J Med Sci. 2005 Feb;59(2):57-63.[pubmed]
9. De Vivo A, Mancuso A, Giacobbe A, et al. Thyroid function in women found to have early pregnancy loss. Thyroid. 2010 Jun;20(6):633-7. doi: 10.1089/thy.2009.0323.[pubmed]
10. Vaidya B, Anthony S, Bilous M, et al. Detection of thyroid dysfunction in early pregnancy: Universal screening or targeted high-risk case finding? J Clin Endocrinol Metab. 2007 Jan;92(1):203-7. Epub 2006 Oct 10. DOI:10.1210/jc.2006-1748.[pubmed]
11. Casey BM, Dashe JS, Wells CE, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005 Feb;105(2):239-45.[pubmed]
12. Goel P, Radotra A, Devi K, et al. Maternal and perinatal outcome in pregnancy with hypothyroidism. Indian J Med Sci. 2005 Mar;59(3):116-7.[pubmed]
13. Idris I, Srinivasan R, Simm A, et al. Maternal hypothyroidism in early and late gestation: effects on neonatal and obstetric outcome. Clin Endocrinol (Oxf). 2005 Nov;63(5):560-5.[pubmed]
14. Casey BM. Subclinical hypothyroidism and pregnancy. Obstet Gynecol Surv. 2006 Jun;61(6):415-20; quiz 423. DOI:10.1097/01.ogx.0000223331.51424.9b.
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