Thyroid stimulating hormone and thyroid peroxidase antibodies assessment in screening of hypothyroidism in pregnancy

Ashwini Vasant Patle; Anuradha Konda; Vivek Vasant Patle

doi:10.18203/2320-1770.ijrcog20251970

Authors

Ashwini Vasant Patle Department of Obstetrics and Gynaecology, Dr. Babasaheb Ambedkar Memorial Hospital, Central Railway Byculla, Mumbai, Maharashtra, India
Anuradha Konda Department of Obstetrics and Gynaecology, Dr. Babasaheb Ambedkar Memorial Hospital, Central Railway Byculla, Mumbai, Maharashtra, India
Vivek Vasant Patle Department of Endocrinology, St. Stephens Hospital, St. Stephen's Hospital Marg, Tis Hazari, New Delhi, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251970

Keywords:

Hypothyroidism, Pregnancy, TSH

Abstract

Background: Thyroid dysfunction in pregnancy is often underdiagnosed due to overlapping physiological changes, yet it poses significant risks to maternal and foetal outcomes. This study aimed to evaluate role of anti-thyroid peroxidase (TPO) antibodies alongside thyroid stimulating hormone (TSH) in diagnosing and guiding treatment for hypothyroidism in pregnant women.

Methods: A prospective cohort study was conducted from September 2019 to June 2021 at a tertiary hospital in Mumbai among antenatal women at booking visit. TSH, free T4, and anti-TPO antibodies were measured using chemiluminescent immunoassay. Follow-up and treatment were based on trimester-specific reference ranges and standard guidelines. Statistical analysis was done with significance set at p<0.05.

Results: Hypothyroidism was found in 11.46% pregnant women (n=253) using TSH cutoff level of 4.0 µIU/ml. The prevalence of anti-TPO antibodies was 5.1%. Among anti-TPO antibody-positive cases, 23.08% had history of miscarriage. Out of 13 participants who tested positive for anti-TPO antibodies, 6 had TSH levels above upper reference limit (4 mIU/l). Participants with borderline TSH levels were followed up; at the second follow-up, 1 out of 72 participants had TSH >4 mIU/l and was started on treatment. At third follow-up, 5 out of 69 participants had TSH >4 mIU/l and were also treated accordingly.

Conclusions: A significant association was observed between elevated TSH levels and presence of anti-TPO antibodies. A notable decrease in mean TSH levels was observed in second and third visits compared to baseline values among pregnant women with borderline TSH, without thyroid hormone supplementation.

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