A Study On Relation Of Subclinical Hypothyroidism During Pregnancy With Its Outcomes In Gujarat

ABSTRACT

INTRODUCTION:Pregnancy is a period that places great physiological stress on both the mother and the fetus. When pregnancy compounded by endocrine disorders such as hypothyroidism, the potential for maternal and fetal adverse outcomes can be immense. Screening for subclinical hypothyroidism is essential in all pregnant women, especially in the Indian context, as Indian women have increased risk of developing iodine deficiency during pregnancy. Hence, this study planned to evaluate the effect of subclinical hypothyroidism on pregnancy outcomes.METHOD:It was a prospective analytical study. Sample size consisted of 73 pregnant women attending antenatal OPD. Thyroid profile (serum TSH, FT3 and FT4) was done during first visit. The results analyzed and SCH decided as per trimester specific cutoffs TSH >2.5mIU/L in 1st trimester, >3mIU/L in 2ndtrimester and >3.5mIU/L in 3rd trimester. Information regarding general characteristics of participants recorded. The participants followed up to assess the mode of delivery, maternal and fetal outcome and any associated co-morbidities. Women with SCH treated accordingly. RESULTS: Seventy-three antenatal women underwent thyroid screening, of them 24.7% had subclinical hypothyroidism. Proportion of SCH women having age less than 25 years was 55.6% compared to 72.3% in euthyroid women. No significant difference observed between SCH and euthyroid groups for iodized salt consumption, type of diet and BMI (p>0.05). Compared with euthyroid status, SCH was associated with higher rates of High blood pressure (HBP) (27.8% vs 7.3%, p=0.02) and Low birth weight among babies (38.9% vs 14.5%, p=0.03). Proportion of Anaemia and Poor APGAR score was also high in SCH women compared to euthyroid. However, the significance was only marginally high. (Anaemia-72.2% vs 45.5%, p=0.049; Poor APGARscore-27.8% vs 9.1%, p=0.045).CONCLUSION:Prevalence of subclinical hypothyroidism among pregnant women is fairly high among Indians. Pregnant women with SCH had unfavourable maternal and fetal outcomes specifically there is an increased risk of high blood pressure and low birth weight babies. Thus, routine maternal thyroid function testing is necessary to improve maternal and [Type text]perinatal outcomes.