Prevalence of thyroid dysfunction and impact on maternal and fetal outcome in Central Indian pregnant women
Keywords:Central-Indian, Maternal and fetal outcome, Pregnant women, Thyroid dysfunction
Introduction: Thyroid dysfunctions have become common endocrine problems in pregnant women. It is now well established that not only overt, but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are very few data from India about the prevalence of thyroid dysfunction in pregnancy. In this study, we determined the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Central Indian Indore Pregnant Women.
Methods: Total 300 pregnant women between the 13 and 26 weeks of gestation were recruited for this study who is residing in Indore. In all patients routine obstetrical investigations, TSH tests were done. Anti-TPO antibody tests and Free T4 were done in patients with deranged TSH. The obstetrical and perinatal outcomes were recorded. Almost all the patients were followed up to delivery.
Results: The prevalence of hypothyroidism and hyperthyroidism was 13 and 4%, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (22.2 versus 11.6%) and placental abruption (22.2 versus 2.0%). Subclinical hypothyroidism was associated with preeclampsia (30.0 versus 11.6%) as compared to the euthyroid patients. Adverse fetal outcomes in overt hypothyroidism included spontaneous abortion (22.2 versus 6.6%), preterm birth (44.4 versus 30.0%), low birth weight (66.6 versus 30.0%), intrauterine growth retardation (33.3 versus 10.0%), and fetal death (22.2 versus 0%) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (2.0 versus 6.6%), preterm delivery (5.2 versus 30.0%), low birth weight (11.2 versus 30.0%), and intrauterine growth retardation (4.4 versus 10 %) as compared to the euthyroid women.
Conclusions: The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.
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