Hypothyroidism and its influence on maternal and perinatal outcomes: insights from a hospital-based retrospective study

Bushra Ahmad; Naima Chaudhary; Shipra Srivastava; Shivani Sharma

doi:10.18203/2320-1770.ijrcog20253533

Authors

Bushra Ahmad Department of Obstetrics and Gynecology, St. Stephen’s Hospital, Delhi, India
Naima Chaudhary Department of Obstetrics and Gynecology, St. Stephen’s Hospital, Delhi, India
Shipra Srivastava Department of Obstetrics and Gynecology, St. Stephen’s Hospital, Delhi, India
Shivani Sharma Department of Obstetrics and Gynecology, St. Stephen’s Hospital, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20253533

Keywords:

IUGR, Hypothyroidism, Low birth weight, Preeclampsia, Preterm, TSH

Abstract

Background: Hypothyroidism during pregnancy is a prevalent endocrine disorder that significantly impacts maternal and perinatal health in the form of infertility, early pregnancy loss, PIH, anaemia, IUGR, PROM, preterm labour, neonatal mortality and morbidity. This retrospective hospital-based study aimed to evaluate the maternal and fetal outcomes associated with hypothyroidism in pregnant women.

Methods: Medical records of pregnant women diagnosed with hypothyroidism were reviewed to assess clinical characteristics, treatment status, and pregnancy outcomes. Maternal complications such as anaemia, preeclampsia, PPH, hypertension, miscarriage were recorded alongside perinatal outcomes including preterm birth, low birth weight, and intrauterine growth restriction. A total of 550 antenatal women with singleton pregnancies and without any pr-existing medical disorder were screened. All patients were monitored up to the point of delivery, allowing for comparison of outcomes across the three groups.

Results: Among the study cohort of 550 antenatal women, 70 were found to have hypothyroidism with an estimated prevalence of 12.72, largely comprising subclinical cases. A higher incidence of hypothyroidism was seen among multigravida patients. Lower segment cesarean section (LSCS) was the most common mode of delivery in the women with hypothyroidism. In addition, hypothyroid mothers experienced higher incidences of adverse outcomes such as preeclampsia, miscarriage, preterm labor, low birth weight infants, IUGR, foetal distress and need for NICU admission as compared to euthyroid mothers. Early identification and treatment with levothyroxine were associated with improved maternal and fetal outcomes.

Conclusions: Hypothyroidism in pregnancy is associated with significant risks for both mother and child. Routine screening and timely treatment are critical measures to mitigate these risks and improve pregnancy outcomes. The findings highlight the necessity of universal thyroid function screening protocols in antenatal care to ensure optimal maternal and perinatal health.

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References

Glinoer D. The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status. Best Pract Res Clin Endocrinol Metab. 2004;18(2):133-52.

Kankanamalage OM, Zhou Q, Li X. Understanding the Pathogenesis of Gestational Hypothyroidism. Front Endocrinol (Lausanne). 2021;12:653407.

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.

Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2007;92(8_supplement):s1-7.

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

Je H. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341:549-55.

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.

Korde VR, Barse SP, Barla JS. Prevalence of thyroid dysfunctions in pregnant women: a prospective study in a tertiary care hospital in Maharashtra, India. Int J Reprod Contracept Obstet Gynecol. 2018;7:3211-5.

Stagnaro-Green A, Pearce EN. Thyroid disorders in pregnancy. Nat Rev Endocrinol. 2012;8(11):650-8.

Sahay RK, Nagesh VS. Hypothyroidism in pregnancy. Indian J Endocrinol Metab. 2012;16(3):364-70.

Girling J. Thyroid disease in pregnancy. Obstet Gynecol Reprod Med. 2008;18:10.

Alfadda A, Tamilia M. Preeclampsia-like syndrome that is associated with severe hypothyroidism in a 20-week pregnant woman. Am J Obstet Gynecol. 2004;191(5):1723-4.

Twig G, Shina A, Amital H, Shoenfeld Y. Pathogenesis of infertility and recurrent pregnancy loss in thyroid autoimmunity. J Autoimmun. 2012;38:J275-81.

Manju VK, Sathiamma PK. Maternal outcome in thyroid dysfunction. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2361-6.

Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341(8):549-55.

Sreelatha S, Nadagoudar S, Devi AL. The study of maternal and fetal outcome in pregnant women with thyroid disorders. Int J Reprod Contracept Obstet Gynecol. 2017;6(8):3507-13.