DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20201785

Study of implications of thyroid status over feto-maternal outcomes in pregnancy

Smruti Gedam, Bharat Bhushan

Abstract


Background: Thyroid disorders are reported at clinically significant prevalence during pregnancy, affecting ~5% of all pregnancies. Maternal thyroid status during pregnancy purportedly affects fetal as well as maternal outcomes. The objective of present study was to analyse the relationship of thyroid status in pregnancy and various maternal and fetal outcomes.

Methods: In this hospital based observational study, a total of 913 pregnant women were enrolled as per fixed criteria and all the study participants were screened for thyroid disorders. Further, they were followed up throughout pregnancy and puerperium and evaluated for various maternal and fetal complications by predefined outcome measures. The results were compared by subgroup analysis.

Results: Of the 913 patients screened, 105 were diagnosed with thyroid abnormality and followed up till delivery, with newborn thyroid profile on day 7. Total 49 patients were diagnosed with anaemia (46.66%), of which 46 (43.80%) had subclinical hypothyroidism (p <0.05); along with pregnancy induced hypertension in 42 (40%) cases of which 40 (38.09%) had subclinical hypothyroidism were observed to have statistically significant associations. Intrauterine growth restriction (IUGR) (37, 35.23%) and prematurity (19, 18.1%) were the most common fetal occurrences; the association of IUGR and subclinical hypothyroidism being statically significant.

Conclusions: Thyroid disorders during pregnancy are commonly associated with maternal and fetal complications and thyroid profile is recommended as universal screening method in early pregnancy to diagnose and start required treatment early.


Keywords


Fetal complication, Maternal complication, Pregnancy, Thyroid status

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References


Eastman CJ. Screening for thyroid disease and iodine deficiency. Pathol. 2012;44(2):153-9.

Glinoer D, Nayer PD, Bourdoux P, Lemone M, Robyn C, Steirteghem AV, et al. Regulation of maternal thyroid during pregnancy. The J Clin Endocrinol Metabol. 1990;71(2):276-87.

Khandakar MA, Ali MS, Kahtun M. Thyroid status of normal pregnant women in Dhaka City. Mymensingh Med J. 2002;11(1):1-5.

Biondi B, Cooper DS. The clinical significance of subclinical thyroid dysfunction. Endocrine Rev. 2007;29(1):76-131.

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 Obstetrics. 2010 Feb 1;281(2):215.

Okosieme OE, Lazarus JH. Thyroid dysfunction in pregnancy: optimizing fetal and maternal outcomes. Expert Review Endocrinol Metabol. 2010;5(4):521-9.

Joshi D, Dewan R, Bharti R, Thariani K, Sablok A, Sharma M, et al. Feto-maternal outcome using new screening criteria of serum TSH for diagnosing hypothyroidism in pregnancy. J Clin Diag Res. 2015;9(4):QC01.

Saraladevi R, Nirmala Kumari T, Shreen B, Usha Rani V. Prevalence of thyroid disorder in pregnancy and pregnancy outcome. IAIM. 2016;3(3):1-1.

Ajmani SN, Aggarwal D, Bhatia P, Sharma M, Sarabhai V, Paul M. Prevalence of overt and subclinical thyroid dysfunction among pregnant women and its effect on maternal and fetal outcome. J Obstet Gynecol India. 2014;64(2):105-10.

Meena DS, Bhati I, Bora S, Meena S. Study of thyroid dysfunction in pregnancy. Int J Curr Microbiol App Sci. 2015;4(9):91-7.

Nazarpour S, Tehrani FR, Simbar M, Azizi F. Thyroid dysfunction and pregnancy outcomes. Iran J Reprod Med. 2015;13(7):387.

Allan WC, Haddow JE, Palomaki GE, Williams JR, Mitchell ML, Hermos RJ, et al. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Scree. 2000;7(3):127-30.