Prevalence of subclinical hypothyroidism in North-Indian pregnant women

Authors

  • Manisha Goel Department of Obstetrics & Gynaecology, Santosh Medical College and Hospital, Ghaziabad, UP, India
  • Amita Sharma Department of Obstetrics & Gynaecology, Santosh Medical College and Hospital, Ghaziabad, UP, India
  • Alpana Agrawal Department of Obstetrics & Gynaecology, Santosh Medical College and Hospital, Ghaziabad, UP, India
  • Manisha Gupta Department of Obstetrics & Gynaecology, Santosh Medical College and Hospital, Ghaziabad, UP, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20150422

Keywords:

Pregnancy, Overt hypothyroidism (OH), Sub clinical hypothyroidism (SCH), Prevalence

Abstract

Background: It is now well established that not only overt but subclinical thyroid dysfunction can also have adverse effects on fetal and maternal outcomes. In recent years several studies show a much larger prevalence of SCH and marked variation between different ethnic groups. The aim of this study was to find out the prevalence of subclinical hypothyroidism during first trimester in a teaching hospital in North India.

Methods: A prospective observational study was conducted in all the consecutive first trimester pregnant women attending Santosh Medical College, Hospital, Ghaziabad from June 2014 to April 2015 after institutional ethics approval and consent from the study subjects. Morning samples of serum were tested for TSH. If serum TSH value was more than 2.5mIU/L then Free T4 and TPO Antibody level were estimated.

Results: Serum TSH level was normal in 66.2 % women, 32.5 % women had subclinical hypothyroidism and 1.3 % women had overt hypothyroidism using a first trimester normal reference range of 0.1 to 2.5 mU/l suggested by American Thyroid Association or by the American Endocrine Society.

Using 5 mIU/L as upper limit of TSH suggested by some Indian studies serum TSH level was normal in 90.6 % women, 8.1 % women had subclinical hypothyroidism and 1.3 % women had overt hypothyroidism.

Conclusion: The prevalence of SCH is very high in our study population. We feel that the use of thyroid function reference values based on studies using different populations and different backgrounds can introduce bias in the evaluation of a local population.

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References

Reid Sm, Middleton P, Cossich MC, Crowther CA. Interventions for clinical and subclinical hypothyroidism in pregnancy. Cochrane Database of Systematic Reviews. 2010;7:1–34.

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 Gynecol Obstet. 2010;281:215-20.

Nambiar V, Jagtap VS, Sarathi V, Lila AR, Kamalanathan S, Bandgar TR, et al. Prevalence and impact of thyroid disorders on maternal outcome in Asian-Indian pregnant women. J Thyroid Res. 2011;2011:4290-97.

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: 281-4.

De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: An endocrine society clinical practice Guideline. J Clin Endocrinol Metab. 2012;97:2543-65.

Marwaha RK, Chopra S, Gopalakrishnan S, Sharma B, Kanwar RS, Sastry A, et al. Establishment of reference range for thyroid hormones in normal pregnant Indian women. Br J Obstet Gynaecol. 2008;115:602–6.

Altomare M, LA Vignera S, Asero P, Recupero D, Condorelli RA, Scollo P, et al. High prevalence of thyroid dysfunction in pregnant women. J Endocrinol Invest. 2013;36:407-11.

Blatt AJ, Nakamoto JM, Kaufman HW. National status of testing for hypothyroidism during pregnancy and postpartum. J Clin Endocrinol Metab. 2012;97:777-84.

Mosso ML, Martínez GA, Rojas MP, Margozzini P, Solari S, Lyng T, et al. Frequency of subclinical thyroid problems among women during the first trimester of pregnancy. Rev Med Chil. 2012;140:1401-8.

Feldthusen A, Larsen J, Pedersen P, et al. Pregnancy-induced alterations in mitochondrial function in euthyroid pregnant women and pregnant women with subclinical hypothyroidism; relation to adverse outcome. Journal of Clinical & Translational Endocrinology. 2014;1(1):e13-7.

Li C, Shan Z, Mao J, Wang W, Xie X, Zhou W, et al. Assessment of thyroid function during first-trimester pregnancy: what is the rational upper limit of serum TSH during the first trimester in Chinese pregnant women? J Clin Endocrinol Metab. 2014;99:73–9.

Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, Vaidya B. 2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children. European Thyroid Journal. 2014;3:76-94.

Moncayo H, Moncayo R. The lack of clinical congruence in diagnosis and research in relation to subclinical hypothyroidism. Fertil Steril. 2014;101:e30.

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Published

2017-02-09

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Original Research Articles