Hypothyroidism Among Diabetic Pregnancy and its Effect on Maternal and Fetal Outcome

ABSTRACT

Background: Diabetic Pregnant women with hypothyroidism are associated with adverse obstetric outcome with various maternal and fetal complications. The aim of this study was to evaluate hypothyroidism in diabetic pregnancy and its effect on maternal and fetal outcome. Material & Methods: This cross-sectional study was conducted in department of Obstetrics and Gynaecology, Women & Children Hospital, NHN, Uttara, Dhaka, Bangladesh, during the period from 13th February 2020 to 9th December 2021. Total 120 pregnant women with diabetes were included in this study. All patients were divided into two groups which include- Group A 60 pregnant women with diabetes and Group B 60 pregnant women with diabetes and hypothyroidism. Results: Mean age was 29.3 years (SD±4.9 years) in group A and 29.9 years (SD±6.1 years) in group B. Mean TSH was 2.2 ?IU/ml (SD±1.7 ?IU/ml) and in group A and 4.4 ?IU/ml (SD±3.0 ?IU/ml) in group B. Mean TSH was higher in group B than group A with statistically significantly difference (p< 0.0001). Most of the pregnant women had lower uterine cesarean section in both group A (51.7%) and in group B (68.3%) with statistically significant difference (p=0.0409) between the groups. The commonest maternal complication was fetal distress in both group A (13.3%) and in group B (16.7%). Most of the neonates had normal weight in both group A (83.3%) and group B (78.3%). Majority of the neonates had normal Apgar score in one minute in both group A (50%) and group B (58.3%). The Apgar score in 5 minutes was also normal in most of the neonates of both group A (71.7%) and group B (78.3%). The neonatal mortality rate in group B was 1.7%. The commonest fetal complication was low birth weight in both group A (16.7%) and in group B (21.7%). There was no statistically significant (>0.05) difference among both groups in neonate’s outcome. Conclusion: Fetal distress and preeclampsia are most common complication in diabetic pregnant women with hypothyroidism. For neonates, low birth weight, hypothyroidism and respiratory distress are commonly seen. There is higher death rate of neonates in diabetic pregnant women with hypothyroidism. Majority of the pregnant women needed lower uterine cesarean section for the complications.