DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20161896

To study and compare the obstetric and neonatal outcome of pregnancies complicated with hypothyroidism amongst antenatally detected and treated hypothyroid patients and patients found to be hypothyroid at the time of labor

Parmanand K. Shah, Hemangi K. Chaudhari, Delina A. Mathias

Abstract


Background: To evaluate pregnancy outcome in women with elevated serum thyroid stimulating hormone (TSH) values as compared to those in whom hypothyroidism was treated.

Methods: A prospective interventional comparative study was conducted in the department of obstetrics and gynaecology in King Edward Memorial Hospital, Mumbai, India from 2014 to 2015. A cohort of 60 hypothyroid patients was divided into two groups of 30 each. Group 1, euthyroid (treated hypothyroid) and group 2, hypothyroid at the time of labor and pregnancy outcomes were compared.

Results: All patients in group 1 delivered at term; whereas in group 2, 9 (30%) patients had preterm deliveries and 21 (70%) delivered at term, amongst which 5 patients delivered babies with severe intrauterine growth restriction (IUGR). Neonatal intensive-care unit (NICU) admission were required for 3 neonates in group 1 and 11 (36.67%) neonates in group 2. Group 1 delivered 5 (16.67%) low birth weight babies (weight <2.5 kg) whereas 16 (53.34%) babies had low birth weight in group 2.

Conclusions: Treatment of patients diagnosed with hypothyroidism during pregnancy significantly (p value <0.05) reduced the risk of preterm labor, low birth weight, need for NICU admission.


Keywords


Hypothyroidism, Pregnancy, Obstetric outcome, Neonatal outcome, Cohort study

Full Text:

PDF

References


Lebeau SO, Mandel SJ. Thyroid disorders during pregnancy. Endocrin Meta Clin North Am. 2006;35(1):117-36.

Nambiar V, Jagtap V, Shah N. Prevalence and impact of thyroid disorders on maternal outcome in Asian-Indian pregnant woman. J Thyroid Research. 2011;90(2):489-95.

Toth B, Jeschke U, Rogenhofer N, Scholz C, W├╝rfel W, Thaler CJ. Recurrent miscarriage: current concept in diagnosis and treatment. J Reprod Immunology. 2010;8:25-32.

Casey BM, Dashe JS, Well CE. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;10(5):239-45.

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 Gyne Obst. 2010;281(2):215-20.

Ohashi M, Furukawa S, Michikata K, Kai K, Sameshima H. Risk-based screening for thyroid dysfunction during pregnancy. J Pregnancy. 2013;619718:1-5.

Gaberscek S, Zaletel K. Thyroid physiology and autoimmunity in pregnancy and after delivery. Expert Rev Clin Immunol. 2011;7(5):697-707.

Kurioka H, Takahasshi K, Miyazaki K. Maternal thyroid function during pregnancy and puerperal period. Endocr J. 2005;52(5):587-91.

Gwiezdzinska JK, Burman KD. Levothyroxine treatment in pregnancy: indications, efficacy and therapeutic regimen. J Thyro Res. 2011;84349:1-12.

Tudosa R, Vartej P, Horhoianu I, Ghica C, Mateescu S, Dumitrache I. Maternal and fetal complications of the hypothyroidism related pregnancy. J Clinic Med. 2010;5(2):116-23.

Vaidya B, Antony S, Shields B, Drury J, Hutchison S. Detection of thyroid dysfunction in early pregnancy universal screening or high risk targeted case finding? J Clin Endocronol Metab. 2007;92(1):203-7.

Negro R, Alan Schwartz. Detection and treatment of thyroid in pregnancy. J Clin Endocrinol Metab. 2010;95(4):1699-707.