Prevalence of hypothyroidism in first trimester screening and its association with maternal and foetal outcomes

Ashwini R.; Vijayalakshmi Kandasamy; Sailatha R.

doi:10.18203/2320-1770.ijrcog20232727

Authors

Ashwini R. Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India
Vijayalakshmi Kandasamy Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India
Sailatha R. Department of Obstetrics and Gynecology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232727

Keywords:

APGAR score, Birth weight, Caesarean delivery, Hypothyroidism

Abstract

Background: Maternal hypothyroid is one of the common thyroid disorder. Hypothyroidism in pregnant women who are not treated can cause premature birth, low birth weight, and respiratory distress in the newborn. Objectives were to find out the prevalence of hypothyroidism in pregnant women during first trimester screening and its association with maternal and foetal outcomes.

Methods: The present study was a hospital based study carried out in the department of obstetrics and gynaecology, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, India between January 2021 and January 2023. The study was carried out among the pregnant women in the first trimester visiting the outpatient department of the OBG department during the study period. Based on the thyroid profile obtained, the participants were classified into normal, subclinical hypothyroidism and overt hypothyroidism. They were then followed up to record the maternal and foetal outcome.

Results: A total of 2017 patients were included in the study. The prevalence of hypothyroidism was 15.3%. The distribution of type of delivery was found to be different between hypothyroid and normal groups with more number of women underwent Caesarean delivery (18.24%) in the hypothyroid group than those in normal group. The proportion of low birth weight was also statistically higher (45.28%) in the hypothyroid group than in the normal. Similar pattern was observed with birth asphyxia. The APGAR scores recorded were also significantly lower in the hypothyroid group than in the euthyroid group with p value of less than 0.05.

Conclusions: The prevalence of hypothyroidism was 15.3%. In our study, women with hypothyroidism showed adverse maternal and foetal outcome such as more caesarean deliveries, low birth weight, and poor APGAR scores and were found to be statistically significant when compared to euthyroid women.

Metrics

Metrics Loading ...

References

Lee SY, Cabral HJ, Aschengrau A, Pearce EN. Associations between maternal thyroid function in pregnancy and obstetric and perinatal outcomes. J Clin Endocrinol Metab. 2020;105(5):e2015-23.

Sahay RK, Nagesh VS. Hypothyroidism in pregnancy. Indian J Endocrinol Metab. 2012;16(3):364.

Shinohara DR, da Silva Santos T, de Carvalho HC, Lopes LC, Günther LS, Aristides SM, et al. Pregnancy complications associated with maternal hypothyroidism: a systematic review. Obstet Gynecol Survey. 2018;73(4):219-30.

National Guidelines for Screening of Hypothyroidism during Pregnancy Maternal Health Division Ministry of Health and Family Welfare Government of India. 2014. Available from: https://nhm.gov.in/ images/pdf/programmes/maternal-health/guidelines/National_Guidelines_for_Screening_of_Hypothyroidism_during_Pregnancy.pdf. Accessed on 20 May 2023.

Rajput R, Bajaj S, Ghosh S, Kalra P, Menon AS, Pillai MG, et al. Thyroid disorders in pregnancy: consensus statement of Indian Thyroid Society. Thyroid Res Pract. 2021;18(3).

Yadav V, Dabar D, Goel AD, Bairwa M, Sood A, Prasad P, Agarwal SS, Nandeshwar S. Prevalence of hypothyroidism in pregnant women in India: a meta-analysis of observational studies. J Thyroid Res. 2021;2021.

Taylor PN, Zouras S, Min T, Nagarahaj K, Lazarus JH, Okosieme O. Thyroid screening in early pregnancy: pros and cons. Front Endocrinol. 2018;9:626..

Dhanwal DK, Prasad S, Agarwal AK, Dixit V, Banerjee AK. High prevalence of subclinical hypothyroidism during first trimester of pregnancy in North India. Indian J Endocrinol Metab. 2013;17(2):281.

Sangita A, Aggarwal N, Vinita S, Mohini P. Prevalence of overt and subclinical thyroid dysfunction among pregnant women and its effect on maternal and fetal outcome. J Obstet Gynecol India. 2014;64(April):105-10.

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

Rajput R, Goel V, Nanda S, Rajput M, Seth S. Prevalence of thyroid dysfunction among women during the first trimester of pregnancy at a tertiary care hospital in Haryana. Indian J Endocrinol Metab. 2015;19(3):416.

Agrawal P, Mehta S, Gupta M, Khare P. Prevalence of hypothyroidism in the first trimester pregnancy in primigravida in North. J Obstet Gynecol Res. 2019;6(1):68-70.

Prasad DR, Nair NV, Deepika K. A descriptive study of the prevalence of hypothyroidism among antenatal women and foetal outcome in treated hypothyroid women. Int J Reprod Contracept Obstet Gynecol. 2016;5(6):1892-6.

Titoria M, Vinita S, Suneeta D, 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;215-20.

Diéguez M, Herrero A, Avello N, Suárez P, Delgado E, Menéndez E. Prevalence of thyroid dysfunction in women in early pregnancy: does it increase with maternal age? Clin Endocrinol. 2016;84(1):121-6.