DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222788
Published: 2022-10-28

Prevalence of thyroid disorders in first trimester of pregnancy

Uzma Rani, Rajshree Paladi, Mehvish Anjum

Abstract


Background: More recently there has been growing concern that more marginal degrees of thyroid dysfunction particularly subclinical hypothyroidism (elevated TSH and normal T4 concentration) and isolated hypothyroxinemia (normal TSH and low T4) are associated with fetal loss, prematurity and impaired offspring cognitive function and potential risk for fetal loss. Thus, it would seem logical to systematically screen pregnant woman for thyroid disorders. This study focuses specifically on thyroid screening in first trimester of pregnancy.

Methods: This is a prospective cross-sectional study over 18 months (December 2020 to June 2022) in 300 patients attending the department of obstetrics and gynecology of teaching hospital attached to Khaja Bandanawaz Institute of Medical Sciences (KBNIMS), KBN University, Gulbarga for antenatal check-up during first trimester of pregnancy.

Results: As per our study prevalence of thyroid disorder 14%, subclinical hyperthyroidism 3.67% and subclinical hypothyroidism 10.33%.

Conclusions: According to data of our study, it is very ideal to subject all pregnant women for thyroid screening in first trimester with special emphasis to pregnant women in extremes of age, extremes of BMI, bad obstetric history and adverse outcome in previous pregnancy as it shows significant relationship with risk of having thyroid abnormalities.


Keywords


Thyroid dysfunction, Hypothyroidism, Hypothyroxinemia, Screening, Trimester

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References


Chaker L, Bianco A, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390:1550-62.

Leo SD, Lee SY, Braverman LE. Hyperthyroidism. Lancet. 2016;388:906-18.

Korevaar TIM, Medici M, Visser TJ, Peeters RP. Thyroid disease in pregnancy: new insights in diagnosis and clinical management. Nat Rev Endocrinol. 2017;13:610-22.

Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010;31:702-55.

Cooper DS, Laurberg P. Hyperthyroidism in pregnancy. Lancet Diabetes Endocrinol. 2013;1:238-49.

Velasco I, Taylor P. Identifying and treating subclinical thyroid dysfunction in pregnancy: emerging controversies. Eur J Endocrinol. 2018;178:D1-12.

IKorevaar T, Timmermans SS, de Rijke YB, Visser WEVW, Keizer-Schrama SMPFM, et al. Hypothyroxinemia and TPO antibody positivity are risk factors for premature delivery: the generation R study. J Clin Endocrinol Metab. 2013;98:4382-90.

Chan S, Boelaert K. Optimal management of hypothyroidism, hypothyroxinaemia and euthyroid TPO antibody positivity preconception and in pregnancy. Clin Endocrinol. 2015;82:313-26.

Sejekan PB. Thyroid screening in pregnancy. J Obstet Gynecol of India. 2010;60(3):232-7.

Glinoer D. The Regulation of Thyroid Function in Pregnancy: Pathways of Endocrine Adaptation from Physiology to Pathology. Endocrine Rev. 1997;18(3):404-33.

Lazarus JH, Bestwick JP, Channon S, Paradice R, Maina A, Rees R, et al. Antenatal thyroid screening and childhood cognitive function. N Engl J Med. 2012;366:493-501.

Casey BM, Thom EA, Peaceman AM, Varner MW, Sorokin Y, Hirtz DG, et al. Treatment of subclinical hypothyroidism or hypothyroxinemia in pregnancy. N Engl J Med. 2017;376:815-25.

Recommendations for the management of Thyroid dysfunction in pregnancy. A joint collaboration between the Indian Thyroid Society and Federation of Obstetric and Gynecological Societies of India. 2019.

Sahu MT, Vinita Das, Mittal S, Agarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol Obstet. 2010;281(2):215-20.

Dhanwal DK, Prasad S, Agrawal AK, Dixit V, Banerji AK. Subclinical hypothyroidism in first trimester of pregnancy in North India. Indian J Endocrinol Metabolism. 2013;7(7):160-1.

Mishra S, Jha RK, Natu N. A Study of Subclinical & Overt Hypothyroidism among Pregnant Women Visiting Antenatal Clinic In A Tertiary Care Centre Of Malwa Region. Int J Recent Scientific Res. 2021;12(7):42309-10.

Abramson J, Stagnaro-Green A. Thyroid antibodies and fetal loss: an evolving story. Thyroid. 2001;11(1):57-63.

Negro R, Formoso G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab. 2006;91:2587-91.

Vaidya B, Anthony S, Bilous M, Shields B, Drury J, Hutchison S, et al. Detection of thyroid function in early pregnancy: universal screening or targeted high-risk case finding? J Clin Endocrinol Metabolism. 2007;92(1):203-7.

Gowachirapant S, Melse-Boonstra A, Winichagoon P, Zimmermann MB. Overweight increases risk of first trimester hypothyroxinaemia in iodine-deficient pregnant women. Maternal and Child Nutrition. 2014;10(1):61-71.

American Association of Clinical Endocrinologists. Subclinical Hypothyroidism during Pregnancy: Position Statement from the American Association of Clinical Endocrinologist. Endocr Pract. 1999;5:367-8.