Prevalence of sub clinical hypothyroidism and pregnancy outcome: a prospective comparative study

Authors

  • Bilal Ur Rehman Department of Obstetrics and Gynaecology, Maternity Hospital, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
  • Hiba Gull Department of Obstetrics and Gynaecology, Maternity Hospital, SKIMS, Soura, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20200909

Keywords:

Fetal outcome, Maternal outcome, Prevalence, Subclinical hypothyroidism

Abstract

Background: In pregnancy, subclinical hypothyroidism is more common than overt hypothyroidism, ranging from 15% to 28% in Iodine sufficient region. Evidence suggests that subclinical hypothyroidism is associated with adverse pregnancy outcome. The aim of this study was to find the prevalence of subclinical hypothyroidism in pregnant women and adverse pregnancy outcome.

Methods: This hospital based prospective comparative study was conducted over a period of 6 months from 1st July 2018 to 31st December 2018 in department of obstetrics and gynecology SKIMS Soura Kashmir. All the subjects who fulfilled the inclusion criteria and who consented to participate were screened for subclinical hypothyroidism.

Results: A total of 175 pregnant women participated in the study and subclinical hypothyroidism was diagnosed in 25 pregnant women (14.2%). Most of our patients were in age group 21 to 30 years (69.1%). Pregnant women with subclinical hypothyroidism had significant risk of preeclampsia (35%) and higher cesarean section rate (29.6%). Neonate of women with subclinical hypothyroidism had higher incidence poor Apgar score, NICU admission.

Conclusions: The prevalence of subclinical hypothyroidism is high in pregnant women and the gravity of the complications like pre-eclampsia, neonate with low Apgar score, increased NICU admission, overweight the cost of screening. In this view, we propose screening of all pregnant women in the first trimester for diagnosis.

References

Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017;27(3):315-89.

Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21:1081-125.

Blatt AJ, Nakamoto JM, Kaufman HW. National status of testing for hypothyroidism during pregnancy and postpartum. J Clin Endocrinol Metab. 2012;97:777-84.

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 Scree. 2000;7(3):127-30.

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

Negro R, Stagnaro-Green A. Diagnosis and management of subclinical hypothyroidism in pregnancy. BMJ. 2014;349:g4929.

Mukhtar B, Kamili MMA, Habib O. Prevalence of subclinical hypothyroidism in pregnant females of Kashmir, India. Pulsus J Surg Res. 2017;1:11-4.

Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O. Overt and subclinical hypothyroidism complicating pregnancy. Thyroid. 2002;12(1):63-8.

Potlukova E, Potluka O, Jiskra J, Limanova Z, Telicka Z, Bartakova J. Drahomira Spring; Is age a risk factor for hypothyroidism in pregnancy? An Analysis of 5223 pregnant women. J Clin Endocrinol Metabol. 2012;97(6):1945-52.

Sannaboraiah A, Upadhyaya R, Garag S, Krishnappa S. Subclinical hypothyroidism in pregnancy and outcomes. Int J Reprod Contracept Obstet Gynecol. 2017;6:1215-21.

Wilson KL, Casey BM, Mclntire DD, Halvorson LM, Cunningham FG. Subclinical thyroid disease and the incidence of hypertension in pregnancy. Obstet Gynecol. 2012;119:315-20.

Sharma D, Dixit PV, Gavit Y. Maternal and perinatal outcome in hypothyroidism in pregnancy: a prospective observational study. Int J Reprod Contracept Obstet Gynecol. 2017;6:5548-53.

Saki F, Dabbaghmanesh MH, Ghaemi SZ, Forouhari S, Ranjbar Omrani G, Bakhshayeshkaram M. Thyroid function in pregnancy and its influences on maternal and fetal outcomes. Int J Endocrinol Metab. 2014;12(4):e19378.

Downloads

Published

2020-02-27

Issue

Section

Original Research Articles