Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care center
Background: Thyroid disorders are one of the commonest endocrine problems among pregnant women. It is often argued that it is not only overt, but subclinical thyroid dysfunction also has similar adverse effects on maternal and fetal outcomes. There is a huge deficiency of data from the Indian popula...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Indian Journal of Community Medicine |
| Subjects: | |
| Online Access: | http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2023;volume=48;issue=2;spage=285;epage=290;aulast=Jain |
| _version_ | 1797824383440388096 |
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| author | Prabhat Anju Jain Ashok Ahirwar Shailendra Dwivedi Rama S Rath |
| author_facet | Prabhat Anju Jain Ashok Ahirwar Shailendra Dwivedi Rama S Rath |
| author_sort | Prabhat |
| collection | DOAJ |
| description | Background: Thyroid disorders are one of the commonest endocrine problems among pregnant women. It is often argued that it is not only overt, but subclinical thyroid dysfunction also has similar adverse effects on maternal and fetal outcomes. There is a huge deficiency of data from the Indian population to assess the prevalence of thyroid dysfunction in pregnancy. This study aimed to determine the prevalence of thyroid disorders in pregnancy and their impact on obstetrical outcomes in the Indian population. The study also had the objective of finding a correlation between maternal and fetal thyroid-stimulating hormone (TSH) levels in hypothyroid pregnancies. Materials and Methods: Around 1055 pregnant women in the first and second trimesters were enrolled in the study. A detailed history was noted and general examinations were done. Apart from routine obstetrical investigations, TSH level estimation was done. If the TSH level was deranged, then free T4 (fT4) and free T3 (fT3) levels were also estimated. Furthermore, 50 hypothyroid and euthyroid pregnant women from the same cohort were followed till delivery. Their obstetrical and perinatal outcomes were noted. Results: The prevalence of thyroid dysfunction was 36.5% in this study, which was quite high in the population. Moreover, hypothyroid groups were prone to have pregnancy-induced hypertension (P = 0.03), intrauterine growth restriction (P = 0.05), and preterm delivery (P = 0.04) as compared to control. Cesarean section rate for fetal distress was significantly higher among pregnant hypothyroid women (P = 0.05). Neonatal respiratory distress and low appearance, pulse, grimace, activity, and respiration (APGAR) () scores were significantly more in the hyperthyroidism group (P = 0.04 and P = 0.02, respectively). Maternal TSH was significantly correlated with hemoglobin levels, HbA1c, and systolic blood pressure. Conclusions: Significant adverse effects on maternal and fetal outcomes were seen emphasizing the importance of routine antenatal thyroid screening. |
| first_indexed | 2024-03-13T10:38:09Z |
| format | Article |
| id | doaj.art-896f99897e69485ebb28627238c81d67 |
| institution | Directory Open Access Journal |
| issn | 0970-0218 1998-3581 |
| language | English |
| last_indexed | 2024-03-13T10:38:09Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Community Medicine |
| spelling | doaj.art-896f99897e69485ebb28627238c81d672023-05-18T05:26:12ZengWolters Kluwer Medknow PublicationsIndian Journal of Community Medicine0970-02181998-35812023-01-0148228529010.4103/ijcm.ijcm_242_22Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care centerPrabhatAnju JainAshok AhirwarShailendra DwivediRama S RathBackground: Thyroid disorders are one of the commonest endocrine problems among pregnant women. It is often argued that it is not only overt, but subclinical thyroid dysfunction also has similar adverse effects on maternal and fetal outcomes. There is a huge deficiency of data from the Indian population to assess the prevalence of thyroid dysfunction in pregnancy. This study aimed to determine the prevalence of thyroid disorders in pregnancy and their impact on obstetrical outcomes in the Indian population. The study also had the objective of finding a correlation between maternal and fetal thyroid-stimulating hormone (TSH) levels in hypothyroid pregnancies. Materials and Methods: Around 1055 pregnant women in the first and second trimesters were enrolled in the study. A detailed history was noted and general examinations were done. Apart from routine obstetrical investigations, TSH level estimation was done. If the TSH level was deranged, then free T4 (fT4) and free T3 (fT3) levels were also estimated. Furthermore, 50 hypothyroid and euthyroid pregnant women from the same cohort were followed till delivery. Their obstetrical and perinatal outcomes were noted. Results: The prevalence of thyroid dysfunction was 36.5% in this study, which was quite high in the population. Moreover, hypothyroid groups were prone to have pregnancy-induced hypertension (P = 0.03), intrauterine growth restriction (P = 0.05), and preterm delivery (P = 0.04) as compared to control. Cesarean section rate for fetal distress was significantly higher among pregnant hypothyroid women (P = 0.05). Neonatal respiratory distress and low appearance, pulse, grimace, activity, and respiration (APGAR) () scores were significantly more in the hyperthyroidism group (P = 0.04 and P = 0.02, respectively). Maternal TSH was significantly correlated with hemoglobin levels, HbA1c, and systolic blood pressure. Conclusions: Significant adverse effects on maternal and fetal outcomes were seen emphasizing the importance of routine antenatal thyroid screening.http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2023;volume=48;issue=2;spage=285;epage=290;aulast=Jainfetal complicationsfirsthypothyroidismmaternal complicationspregnancy trimesterthyrotropin |
| spellingShingle | Prabhat Anju Jain Ashok Ahirwar Shailendra Dwivedi Rama S Rath Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care center Indian Journal of Community Medicine fetal complications first hypothyroidism maternal complications pregnancy trimester thyrotropin |
| title | Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care center |
| title_full | Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care center |
| title_fullStr | Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care center |
| title_full_unstemmed | Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care center |
| title_short | Prevalence and complications of subclinical and overt hypothyroidism in pregnancy at North Indian tertiary care center |
| title_sort | prevalence and complications of subclinical and overt hypothyroidism in pregnancy at north indian tertiary care center |
| topic | fetal complications first hypothyroidism maternal complications pregnancy trimester thyrotropin |
| url | http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2023;volume=48;issue=2;spage=285;epage=290;aulast=Jain |
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