Prevalence and incidence of thyroid disorder during pregnancy in Bangladesh - a tertiary care hospital based study

Abstract

Objectives: To establish the prevalence and incidence of thyroid dysfunction during pregnancy in a tertiary care center in Bangladesh.Methodology: 749 cases were randomly selected among the pregnant women who reported to antenatal clinic. Later 121 women were excluded as they were already diagnosed cases of thyroid disorder. The rest were investigated for thyroid stimulating hormone (TSH) and if required then they were also investigated for free triiodothyronine (FT3), free thyroxine (FT4), and thyroid peroxidase antibody (TPOAb). Thyroid status was classified according to TSH level – euthyroidism, subclinical hypothyroidism, overt hypothyroidism and hyperthyroidism (sub-clinical hyperthyroidism, Graves’ disease/toxic multinodular goiter, transient hyperthyroidism of pregnancy). And all patients were divided into 2 groups – normal/euthyroidism and abnormal/thyroid disorder, considering their thyroid status.Result: The prevalence of thyroid disorder during pregnancy was 34.98% and incidence was 22.45%. The mean TSH levels (μIU/mL) of 1st, 2nd and 3rd trimester were 2.67±3.59, 2.39±1.87 and 2.74±3.98, respectively. Significant number of overt hypothyroid cases were detected among rural people (P – 0.004). There were significant difference of incidence of euthyroid (P – 0.029) and SCHTh (P - 0.031) cases at different stages of gestation. There were also significant number of cases with goiter (P - ˂0.001) and TPOAb (P – ˂0.001) in different patient groups. Conclusion: Thyroid disorders are common in pregnancy. Early detection and proper treatment of thyroid dysfunction can help for better outcome. Hence, thyroid function test must be advised to all pregnant women.

Keywords

• pregnancy, euthyroidism, subclinical hypothyroidism, overt hypothyroidism and hyperthyroidism