Thyroid dysfunction in pregnancy - a tertiary care centre experience

Abstract

Introduction: Thyroid dysfunction has profound effect on both the mother and the fetus. This study was conducted in order to evaluate the thyroid function in pregnancy and its association with adverse maternal and fetal outcome. Method: This was a cross sectional epidemiological study. 162 patients were recruited for the study and patients with chronic illnesses were excluded via a detailed history, examination and investigations. Thyroid function tests including anti thyroid peroxidase antibody levels were done to assess the thyroid status. Patients were categorized into subclinical hypothyroidism, overt hypothyroidism or hyperthyroid based on thyroid function test results. Maternal and fetal outcomes were ascertained and the association of outcomes with the thyroid dysfunction was assessed. Results: 162 pregnant females irrespective of their gestational age were selected for the study. However, fetal and perinatal outcomes could be obtained in 138 cases. Prevalence of thyroid dysfunction among pregnant mothers was found to be 24.07% and subclinical hypothyroidism (18.9%) was the commonest thyroid disorder. There was a clear relationship between thyroid dysfunction and history of abortion, pre-term delivery and stillbirths. Prevalence of low birth weight is significantly higher in mothers with thyroid dysfunction. Conclusions: Thyroid dysfunction is common during pregnancy and sub clinical hypothyroidism is the commonest thyroid disorder. Thyroid dysfunction has a clear association with poor fetal outcome with regards to abortions, pre-term delivery, still births and low birth weight.

Keywords

• pregnancy, thyroid dysfunction, adverse pregnancy outcome, autoimmunity