Prevalence of overt and subclinical thyroid dysfunction among women and its effects on maternal and fetal outcome

Authors

  • Puja Kumari Department of Obstetrics and Gynecology, N.M.C.H, Jamuhar, Bihar, India
  • Sadhana Singh Department of Obstetrics and Gynecology, N.M.C.H, Jamuhar, Bihar, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20181988

Keywords:

Fetal outcome, Maternal outcome, Prevalence, Thyroid dysfunction

Abstract

Background: Objective of present study was to determine the current prevalence of thyroid dysfunction in normal pregnant women and to study the impact of thyroid dysfunction on maternal and fetal outcome.

Methods: 400 pregnant women between 13 and 26 weeks of gestation were registered for the study. Apart from routine obstetrical investigations, TSH tests were done. Free T4 and anti-TPO antibody tests were done in patients with deranged TSH. Patients were followed up till delivery. Their obstetrical and perinatal outcomes were noted.

Results: The prevalence of hypothyroidism and hyperthyroidism was and 1.25%, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (16.6 vs. 7.8%) and placental abruption (16.6 vs. 0.8%). Subclinical hypothyroidism was associated with preeclampsia (22.3 vs. 7.8%) as compared to the euthyroid patients. Adverse fetal outcome in overt hypothyroidism  included spontaneous abortion (16.6 vs. 2.39%), preterm birth (33.3 vs. 5.8%), low birth weight (50 vs. 12.11%), intrauterine growth retardation (25 vs. 4.9%), and fetal death (16.6 vs.7%) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (5.5 vs. 2.39%), preterm delivery (11.2 vs. 5.8%), low birth weight (25 vs. 12.11%), and intrauterine growth retardation (8.4 vs. 4.9%) as compared to the euthyroid women.

Conclusions: The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.

References

Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D et al. Management of thyroid dysfunction during pregnancy and postpartum: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2007; 92(8):1-47.

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

Sharma PP, Mukhopadhyay P, Mukhopadhyay A. Hypothyroidism in pregnancy. J Obstet Gynecol India. 2007;57:331-4.

Stagnaro-Green A. Overt hyperthyroidism and hypothyroidism during pregnancy. Clin Obstet Gynecol. 2011; 54(3):478-87.

Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988–1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-99.

Glinoer D. Thyroid hyperfunction during pregnancy. Thyroid. 1998;8(9):859-64.

So LB, Mandel SJ. Thyroid disorders during pregnancy. Endocrinol Metab Clin North Am. 2006;35:117-36.

Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy hypothyroidism in pregnancy and postpartum. Thyroid. 2011;21(10):1081-125.

American College of Obstetricians and Gynaecologists. Clinical American management guidelines for obstetrician–gynaecologists: gestational diabetes: ACOG Practice Bulletin No. 30. Obstet Gynecol. 2001; 98:525-38.

Allan WC, Haddow JE, Palomaki GE, Williams JR, Mitchell ML, Hermos RJ et al. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Screen. 2000;7:127–30.

Benhadi N, Wiersinga WM, Reitsma JB, Vrijkotte TG, Bonsel GJ. Higher maternal TSH level in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death. Eur J Endocrinol. 2009; 160(6):985-91.

Goel P, Radotra A, Devi K, Malhotra S, Aggarwal A, Huria A. Maternal and perinatal outcome in pregnancy with hypothyroidism. Indian J Med Sci. 2005;59:116-7.

Sahu MT, Das V, 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;281:215-20.

Downloads

Published

2018-05-26

Issue

Section

Original Research Articles