ABSTRACT
The aim of this study was to know whether the alterations of maternal thyroid function were also present in the newborn at birth. Retrospective study of thyroid related hormones in pregnant mothers at time of delivery and their cord blood samples. Department of Obstetrics and Gynecology, Government Mian Munshi Hospital and Centre for Nuclear Medicine [CENUM], Mayo Hospital, Lahore. 175 women delivered during the year 2001. maternal and cord serum T[4] and TSH. The mean age of women was 27.5 +/- 4.7 years and average weight of their babies was 3.3 +/- 0.6 kg. The median T[4] and TSH concentrations of mothers, particularly T[4], at delivery were significantly higher than controls [p<0.001 and p<0.01 respectively]. T[4] levels were negatively correlated to TSH levels in both mothers and neonates with low degrees of correlation. The median T[4] was significantly lower and median TSH was significantly higher in neonates as compared to mothers [p<0.001]. A relatively higher degree of correlation was observed among T[4] levels of mothers and neonates. The neonates of mothers having TSH levels below 0.35% mIU/L exhibited a heterogeneous patter of T[4] and TSH levels, which were not consistent with their mothers. In mothers who had TSH level within normal euthyroid range [0.36-4.0 mIU/L] neonates had T[4] levels within normal euthyroid range but 13.7% of them had TSH levels above 10 mIU/L. Overall 13.1% neonates had TSH level above 10mIU/L which indicated mild degree of iodine deficiency in Lahore. Neonates of about 13% pregnant women are at risk of iodine deficiency. Iodine supplementation in women of reproductive age is required before pregnancy as mild iodine deficiency is prevalent in Lahore
ABSTRACT
To study goiter and thyroid dysfunction in female adolescents residing in Lahore referred to Centre for Nuclear Medicine [CENUM], Mayo Hospital for thyroid scanning and thyroid function tests. Design: Retrospective study of thyroid size, thyroid scan patterns and serum FT, and TSH levels. Setting: Centre for Nuclear Medicine [CENUM], Mayo Hospital, Lahore Patients: 350 female adolescent referred during September 2002 to April 2003. Main outcome measures: adolescent goiter, thyroid nodules, hyperthyroidism, hypothyroidism, Graves' disease, toxic multinodular goiter. Among 350 adolescents 212[60.6%] had goiter of various grades mostly visible. Among goiterous patients 136[64.2%] had diffuse and 76 [35.8%] had nodular presentation. The number of patients with solitary nodular goiter [20.7%] was more than multinodular goiter [15.1%] and number of patients with solitary cold nodule [16.5%] was more than functioning nodule [4.2%]. The incidence of biochemical thyroid dysfunction, both overt and subclinical, was detected in 42[19.8%] patients and was significantly more frequent in patients with nodular than diffuse presentation [29% VS 14.7%; p<0.001] and in multinodular than solitary nodular goiter [p<0.005]. More than 80% of the patients with solitary nodular goiter were euthyroid. Simple goiter was detected in 116[54.7%], Graves' disease in 5[2.4%] and toxic multinodular goitre in 4[1.9%] patients. Overall incidence of hypothyroidism was more than double as compared to hyperthyroidism. Incidence of nodularity and hypothyroidism was more in large goiter but duration of goiter was not significant in promoting nodularity. Goiterous adolescents need urgent attention because they don't have just diffuse hypertro- phy with normal thyroid function. Many are afflicted with dysfunction and nodularity, particularly solitary cold nodule bearing risk of thyroid malignancy