To study the prevalence of spontaneous abortions in pregnant women with hypothyroidism in the tertiary referral centre

Shameel Faisal, Satish Tibrewala, Sana Afreen, Raksha Shetty


Background: The thyroid diseases are the commonest endocrine disorders affecting women of reproductive age group maternal hypothyroidism is the most common disorder of thyroid function in pregnancy and has been associated with spontaneous pregnancy loss, pre eclampsia, preterm delivery, antepartum hemorrhage, low birth weight, fetal distress and reduced intellectual function of the offspring. The objective was to study the prevalence of spontaeous abortions in the pregnant women with hypothyroidism.

Methods: All cohort cases were selected prospective from consecutive pregnant female attending the antenatal clinics of tertiary referral centre in study period of three years. FT3, FT4 and serum TSH were done in them and the results were compared Pregnancy specific reference ranges were also applied. The patients were divided into two groups based on time of hypothyroidism detection and diagnosis. The past history or prevalence of Spontaneous Abortions were compared in both the groups.

Results: The prevalence of hypothyroidism was 5.6% in women routine antenatal clinic which was highly significant. The prevalence of spontaneous abortion in the past in the group A was 18% as compared to 28% in group B, difference being highly significant.

Conclusions: Hypothyroidism is highly prevalent in patients who had obstetric repercussions. Early diagnosis and thyroxine replacement can prevent complications in the future pregnancies. Thyroid function tests should be included in the list of routine investigation done in an antenatal mother and should become a mandatory investigation in patients with previous adverse pregnancy outcomes.


Hypothyroidism in pregnancy, Subclinical hypothyroidism, Spontaneous abortion

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Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev. 1997;18:404-33.

Casey BM, Leveno KJ. Thyroid disease in pregnancy. Obstet Gynecol. 2006;108(5):1283-92.

Le Bean SO, Mandal SJ. Thyroid disorders during pregnancy. Endocrinal Metab Clin N Am. 2006;35:117-36.

Panesar NS. Reference intervals for thyroid hormones in pregnant Chinese women. Ann Clin Biochem. 2001;38:329-32.

Poonam G, Radotra A, Devi K, Malhotra S, Aggarwal A, Huria A. Maternal and perinatal outcome in pregnancy with hypothyroidism. Indian J Med Sci. 2005;59(3):116-7.

Glinoer D, Soto MF, Bourdoux P, Lejeune B, Delange F, Lemone M, et al. Pregnancy in patients with mild thyroid abnormalities: maternal and neonatal repercussions. J Clin Endocrinol Metal. 1991;79:197-204.

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

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(7):2587-91.

Rao VR, Lakshmi A, Sadhnani Md. Prevalence of hypothyroidism in recurrent pregnancy loss in first trimester. Indian J Med Sci. 2008;62:357-61.

Sharma PP, Mukhopadhyay P, Mukhopadhyay A, Muraleedharan PD, Nulufer B. Hypothyroidism in pregnancy. J Obstet Gynecol India. 2007;57(4):331-4.

Cleary-Goldman J, Malone FD, Lambert-Messerlian G, Sullivan L, Canick J, Porter TF, et al. Maternal thyroid hypofunction and pregnancy outcome. Obstet Gynecol. 2008;112(1):85-92.

Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd EW, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105:239-45.

Gilbert RM, Hadlow NC, Walsh JP, Fletcher SJ, Brow SJ, Stuckey BG, et al. Assessment of thyroid function during pregnancy; first trimester (weeks 9-13) reference intervals derived from Western Australian women. Med J Aust. 2008;189(5):250-3.

Goel P, Kaur J, Saha PK, Tandon R, Devi L. Prevalence, associated risk factors and effects of hypothyroidism in pregnancy: a study from north India. Gynecol Obstet Invest. 2012;74(2):89-94.