scholarly journals Analysis of the thyroid status of pregnant women in the region of mild iodine deficiency

2021 ◽  
pp. 276-284
Author(s):  
L. A. Suplotova ◽  
O. B. Makarova ◽  
E. N. Maksyukova ◽  
L. N. Smolina
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Subclinical Hypothyroidism ◽  
Cognitive Abilities ◽  
Thyroid Dysfunction ◽  
Antenatal Clinic ◽  
Thyroid Status ◽  
Pregnancy And Childbirth ◽  
Biomedical Monitoring ◽  
Negative Effect

Introduction. Thyroid hormones play an important role during pregnancy, providing organogenesis, growth and development of the fetus, participate in the formation and development of the brain and its structures, affecting cognitive abilities. Thyroid dysfunction is associated with the pathological course of pregnancy and childbirth, as well as a negative effect on the fetus. Iodine deficiency, which persists throughout Russia, creates the preconditions for the more frequent development of subclinical hypothyroidism and hypothyroxinemia in pregnant women. Therefore, early detection of thyroid dysfunction during gestation in the region of iodine deficiency is relevant.Aim. To assess the thyroid status in pregnant women in the region of iodine deficiency.Materials and methods. A single-center, prospective, one-sample study was performed in a population of pregnant women registered from June 2019 to December 2019 to the antenatal clinic in Tyumen.Results. According to the results of biomedical monitoring of iodine deficiency in the population of pregnant women in Tyumen, iodine supply improved, as evidenced by the median concentration of ioduria 154.4 μg / l, the frequency of endemic goiter was 0.37%. Continuous screening of women in the 1st trimester of pregnancy without thyroid pathology revealed subclinical hypothyroidism in 21.5% of pregnant women, carriage of antibodies to thyroperoxidase was found in 10.5% of women.Conclusions. Given the persisting problem of iodine deficiency, the widespread occurrence of subclinical hypothyroidism in the population of pregnant women, it is necessary to include the study of thyroid status in the standard of examination of pregnant women when registering in an antenatal clinic for early diagnosis and timely treatment of hypothyroidism. It is also recommended to continue preventive measures aimed at replenishing the iodine deficiency starting from the stage of pregravid preparation. 

scholarly journals Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome

2015 ◽  
Vol 40 (2) ◽  
pp. 52-57 ◽  
Author(s):  
M Sharmeen ◽  
PA Shamsunnahar ◽  
TR Laita ◽  
SB Chowdhury
Keyword(s):  
Adverse Effects ◽  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Adequate Treatment ◽  
In Pregnancy

Objectives: Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome.Methods: We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted.Results: Overt hypothyroidism was significantly (p<0.05) higher in 25 to 44 years age group. However two and three abortions were significantly (p<0.05) higher in overt hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P=0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p<0.05) higher in overt hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications. Significant adverse effects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.Bangladesh Med Res Counc Bull 2014; 40 (2): 52-57

scholarly journals Comparison of universal and targeted screening for thyroid dysfunction in pregnant Egyptian women

2014 ◽  
Vol 171 (2) ◽  
pp. 285-291 ◽  
Author(s):  
Iman Z Ahmed ◽  
Yara M Eid ◽  
Hussein El Orabi ◽  
Hani Refat Ibrahim
Keyword(s):  
Clinical Practice ◽  
Pregnant Women ◽  
Practice Guidelines ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Risk Group ◽  
Low Risk ◽  
Endocrine Society ◽  
Targeted Screening ◽  
Egyptian Women

ObjectiveTo compare universal vs targeted screening for thyroid dysfunction and to estimate the prevalence of hypothyroidism in pregnant Egyptian women.Subjects and methodsA total of 168 of pregnant women who attended the outpatient obstetric clinic at Ain Shams University Hospital (Cairo, Egypt) for antenatal care between September 2011 and December 2011 were enrolled. Based on the detailed data collection and results of laboratory testing, they were subdivided into the high- and low-risk group for thyroid disease according to the most recent Endocrine Society clinical practice guidelines, as well as into groups by trimester for application of American Thyroid Association guidelines. The group values were subjected to statistical analysis for estimating the prevalence of clinical and subclinical hypothyroidism and for identifying significant differences.ResultsOf the 168 patients, 104 were classified into the low-risk group and 64 into the high-risk group. Using the trimesteric and normal population cutoff values for thyroid functions, the prevalence of hypothyroidism was found to be 56% (n=94) and 44.6% (n=75) respectively. No statistically significant differences were found between the high- and low-risk group regarding prevalence of either clinical or subclinical hypothyroidism, and no significant differences were found regarding the prevalence of hypothyroidism in the first, second, or third trimester.ConclusionUse of the most recent Endocrine Society clinical practice guidelines led to missed detection of clinical or subclinical hypothyroidism in 34.5% of pregnant women. Universal screening of pregnant women for thyroid dysfunction should thus be adopted throughout Egypt.

scholarly journals Prevalence of thyroid disorders in pregnancy

2018 ◽  
Vol 7 (9) ◽  
pp. 3493
Author(s):  
Sangeeta Pahwa ◽  
Sabia Mangat
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Screening ◽  
In Pregnancy

Background: Thyroid disorders are among the common endocrine problems in pregnant women. Often overlooked in pregnancy due to nonspecific symptoms and hyper-metabolic state of pregnancy. Western literature shows prevalence of hypothyroidism in pregnancy as 2.5% and hypothyroidism as 0.1-0.4%. There is paucity of data on prevalence of thyroid disorders in India pregnant population. This study was carried out to know prevalence of thyroid disorders in pregnant women in Indian population.Methods: One hundred pregnant women attending antenatal clinic in first trimester were registered. Detailed history and examination was done. Apart from routine basic and obstetrical investigations, TSH, FT3 and FT4 level estimation was done.Results: Prevalence of thyroid dysfunction was high in this study in first trimester pregnant women, with subclinical hypothyroidism in 6%, overt hypothyroidism in 2%, subclinical hyperthyroidism 2 % and overt hyperthyroidism 0%.Conclusions: Prevalence of thyroid disorders, especially subclinical hypothyroidism (6%), overt hypothyroidism (2%) and subclinical hyperthyroidism (2%) was high. To prevent adverse effects on maternal and fetal outcome, we are emphasizing the importance of routine antenatal thyroid screening.

A Prospective Study of Thyroid Function Status in Patients of Haemoglobin E Beta Thalassemia and Correlation with Serum Ferritin Level

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4837-4837
Author(s):  
Tuphan Kanti Dolai ◽  
Shuvra Neel Baul ◽  
Prakas Kumar Mandal ◽  
Rajib De ◽  
Prantar Chakrabarti
Keyword(s):  
Correlation Coefficient ◽  
Serum Ferritin ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Serum Ferritin Level ◽  
Conflicts Of Interest ◽  
Ferritin Level ◽  
Thyroid Status ◽  
Beta Thalassaemia ◽  
Serum Tsh

Abstract Introduction Haemoglobin E-beta-thalassaemia (EBT) represent approximately 50 per cent of those affected with severe beta thalassemia.The highest frequencies are observed in India, Bangladesh and throughout Southeast Asia. Endocrinopathies are now amongst the common complications of thalassaemia and it is multifactorial in origin. Iron overload in EBT is also multifactorial. This study was undertaken to evaluate the thyroid dysfunction in patients of EBT and its correlation with serum ferritin levels. Methods EBT patients were evaluated prospectively to assess thyroid dysfunction status and correlate it with serum ferritin levels. High performance liquid chromatography was performed with Bio-rad beta thalassaemia short program variant II. Serum ferritin estimation was done with microplate immunoenzymometric assay and thyroid assay for TSH, free T4 and T3 were done by access 2 Immunoassay System, Beckman Coulter. Results 50 patients with EBT were evaluated. The mean age of patients were 19.7 years (range: 12-47). There were 28 males and 22 females. There were 41(82%) and 9(18%) transfusion dependent and transfusion independent patients respectively and 40(80%) were on chelation therapy. In this cohort 22(44%) patients had thyroid dysfunction. Six (12%) and 16(32%) of patients were having hypothyroidism and subclinical hypothyroidism respectively. Mean ± Standard deviation (S.D) of serum ferritin level with hypothyroidism, subclinical hypothyroidism and euthyroidism was 1077 ± 371.8 ng/ml ,1422 ± 1361.0 ng/ml and 1252 ± 664.4 ng/ml respectively with correlation coefficient =0 [Fig 1 and Fig 2]. Serum ferritin levels do not predict thyroid dysfunction in patients of EBT. Male and female have equal preponderance for thyroid dysfunction. Patients with subclinical hypothyroidism were having few symptoms compared to frank hypothyroidism and majority of symptoms in either scenario were masked by thalassemia itself. Earlier age of onset of EBT is associated more with thyroid dysfunction however the association is not statistically significant (p=0.2). There was no association between spleen size and thyroid dysfunction (p=0.7). Conclusions Thyroid dysfunction was seen in 42% of EBT patients. Prevalence of hypothyroidism was found to be higher in EBT patients compared to general population but a definite correlation with the serum ferritin levels could not be established. Figure 1 Mean serum ferritin level and thyroid status Figure 1. Mean serum ferritin level and thyroid status Figure 2 Correlation of serum TSH and ferritin level (correlation coefficient =0) Figure 2. Correlation of serum TSH and ferritin level (correlation coefficient =0) Disclosures No relevant conflicts of interest to declare.

scholarly journals The influence of diffuse toxic goiter on the course and outcome of pregnancy

2012 ◽  
Vol 61 (4) ◽  
pp. 67-74
Author(s):  
Yulia Sergeevna Lovkova ◽  
Vladimir Vsevolodovich Potin ◽  
Natalya Nikolaevna Tkachenko ◽  
Elisaveta Valeryevna Shelayeva ◽  
Tachira Timurovna Musaeva
Keyword(s):  
Cord Blood ◽  
Pregnant Women ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Autoimmune Thyroiditis ◽  
Subclinical Hypothyroidism ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Status ◽  
Toxic Goiter ◽  
Preterm Rupture Of Membranes

We have studied peculiarities of pregnancy, delivery and neonatal thyroid status in 58 women with diffuse toxic goiter. During pregnancy patients received thyreostatic therapy (imidazole and thiouracil derivates). Examination consisted of assessment of levels of free thyroxin, TSH, autoantibodies to TSH-receptors and autoantibodies to thyroperoxidasis in the blood of pregnant women and in umbilical cord blood. The group of comparison consisted of 58 women without thyroid pathology and 111 women with autoimmune thyroiditis. In women with diffuse toxic goiter preeclampsia, chronic placental insufficiency, preterm rupture of membranes, fetal hypotrophy and hypoxia were observed more frequently. 17 % of newborns of mothers with diffuse toxic goiter had subclinical hyperthyroidism and 54% of newborns — subclinical hypothyroidism, depending of transplacental pass of thyreostatic medications

scholarly journals Prevalence of thyroid disorders among pregnant women at a tertiary care hospital in Rajasthan

2021 ◽  
Vol 10 (3) ◽  
pp. 1111
Author(s):  
Shalini Singh ◽  
Pragya Shree ◽  
Vaibhav Kanti ◽  
Kalpana Kumari ◽  
Rajeev Suchdeva
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
First Trimester ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Second Trimester ◽  
Maternal Weight

Background: Hormonal changes and metabolic demands during pregnancy result in profound alterations in the biochemical parameters of thyroid function. Screening for thyroid disorders and initiation of its management at the earliest stage during first trimester is essential as maternal thyroid failure during the first half of pregnancy has been associated with several pregnancy complications and intellectual impairment in offspring. Aim was to evaluate the prevalence of thyroid dysfunction during the first and second trimester of pregnancy among women of Rajasthan state in India.Methods: The study comprised a cohort of 313 consecutive pregnant women in the first and second trimester that attended the OPD and were admitted as pregnant women in Obstetrics and Gynecology Department of the NIMS Medical College and Hospital, Jaipur, Rajasthan. Thyroid stimulating hormone (TSH) levels and free T4 (fT4) were estimated. The subjects were grouped into six groups based on the value of serum TSH and fT4.Results: Out of 313 antenatal women enrolled in the study, 213 (68%) attended antenatal clinic in first trimester of pregnancy and 100 (32%) women in their second trimester. The prevalence of thyroid dysfunction was 15.97% (overt hypothyroidism 1.28%, subclinical hypothyroidism 4.79%, isolated hypothyroxinemia 4.47%, overt hyperthyroidism 1.92%, and subclinical hyperthyroidism 3.51%). The women with overt hypo- or hyperthyroidism and subclinical hypothyroidism were older than euthyroid women. Maternal weight was high in pregnant women with overt hypothyroidism (58.22±6.18 kg) and subclinical hypothyroidism (52.04±2.94 kg). Gravid status was high in pregnant women with overt hypothyroidism, subclinical hypothyroidism and isolated hypothyroxinemia, but low in hyperthyroid group. History of miscarriage was high in pregnant women with subclinical hypothyroidism.Conclusions: With this study, it was concluded that there is high prevalence of thyroid dysfunction in pregnancy predominantly in rural population of Rajasthan. Majority among these being subclinical hypothyroidism and hypothyroxinemia.

scholarly journals Study on thyroid function test in pregnancy in a tertiary care hospital

2021 ◽  
pp. 20-25
Author(s):  
Ajit Kumar Nayak ◽  
Manorama Swain ◽  
Sujata Misra ◽  
Manju Kumari Jain
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Care Hospital ◽  
Thyroid Disorder ◽  
Singleton Pregnancy ◽  
Free T4

Thyroid disorder is a very common endocrine problem encountered by pregnant women. Maternal thyroid dysfunction is associated with adverse outcome both in mother and fetus. The aim of the study: to find out the prevalence of various thyroid disorders in pregnant women attending antenatal clinic. Materials and methods. This prospective cross-sectional study was carried out in the Department of Obstetrics and Gynecology, F.M. Medical College & Hospital, Balasore, Odisha from June 2020 to May 2021. 220 women with uncomplicated singleton pregnancy were included. Serum Thyroid-stimulating hormone (TSH), free T4 (FT4) and free T3 (FT3) were estimated by using electro-chemiluminescence immunoassay technique. Results. Out of 220 pregnant women screened for thyroid dysfunction, 68 were found to have thyroid disorders. 27.3 % of pregnant women had subclinical hypothyroidism, 1.4 % had overt hypothyroidism, 1.8 % had subclinical hyperthyroidism and 0.5 % had overt hyperthyroidism. Prevalence of subclinical hypothyroidism was 6.36 % when the upper reference limit of TSH level taken as 4 mIU/L. Prevalence of thyroid disorder among pregnant women in the age groups 18–25 years, 26–30 years and 31–40 years were 28.9 %, 32.1 % and 38.9 % respectively. There were 35.5 %, 28 % and 26 % pregnant women with thyroid disorders in the first, second and third trimester respectively. Prevalence of both subclinical and overt hypothyroidism were more in multigravida compared to primigravida. Conclusion. Our study revealed high prevalence of thyroid disorders in pregnant women and maternal subclinical hypothyroidism was the most common pattern.

scholarly journals Prevalence and Impact of Thyroid Disorders on Maternal Outcome in Asian-Indian Pregnant Women

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Vimal Nambiar ◽  
Varsha S. Jagtap ◽  
Vijaya Sarathi ◽  
Anurag R. Lila ◽  
Sadishkumar Kamalanathan ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Asian Indian ◽  
Thyroid Dysfunction ◽  
Thyroid Autoimmunity ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Thyroid Peroxidase ◽  
Study Cohort ◽  
Tertiary Center ◽  
Asian Indian Population

Aims. To establish the prevalence and the effect of thyroid dysfunction on pregnancy outcomes in Asian-Indian population.Subjects and Methods. The study cohort comprised of 483 consecutive pregnant women in the first trimester attending the antenatal clinic of a tertiary center in Mumbai, India. Thyroid hormone levels and thyroid peroxidase antibody were estimated. Patients with thyroid dysfunction were assessed periodically or treated depending on the severity. Subjects were followed until delivery.Results. The prevalence of hypothyroidism, Graves' disease, gestational transient thyrotoxicosis, and thyroid autoimmunity (TAI) was 4.8% (), 0.6% (), 6.4 % (), and 12.4% (), respectively. Forty percent of the hypothyroid patients did not have any high-risk characteristics. Hypothyroidism and TAI were associated with miscarriage ( and , resp.).Conclusions. The prevalence of hypothyroidism (4.8%) and TAI (12.4%) is high. TAI and hypothyroidism were significantly associated with miscarriage.

scholarly journals First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes

2018 ◽  
Vol 21 (1) ◽  
pp. 34-41
Author(s):  
Polina V. Popova ◽  
Ekaterina S. Shilova ◽  
Alexandra S. Tkachuk ◽  
Alexandra V. Dronova ◽  
Anna D. Anopova ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Reference Values ◽  
Subclinical Hypothyroidism ◽  
Reference Interval ◽  
First Trimester ◽  
Specific Reference ◽  
Thyroid Status ◽  
Saint Petersburg ◽  
Increased Risk

Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific reference values so fixed universal cutoff concentrations for thyroid-stimulating hormone (TSH) that were recommended earlier now are put under the question. Population-specific and trimester-specific reference values have not been defined for pregnant women residing in Saint Petersburg. The data concerning the association of maternal thyroid status with GDM development are controversial. Aims. The aim of the study was to determine the reference values of TSH and free thyroxin (fT4) in the first trimester of pregnancy in women living in St. Petersburg, and to assess the relationship between thyroid status and the risk of subsequent development of GDM. Materials and methods. The levels of TSH, fT4 and thyroid peroxidase antibodies (TPO-Ab) were analyzed in 503 pregnant women before the 14th week of gestation. The women underwent oral glucose tolerance test (OGTT) at 2428 weeks to find out those with GDM. The association between thyroid function, thyroid autoimmunity and the risk of GDM we estimated. Results. The reference values for TSH were 0.07 4.40 mU /L, and for fT4 11.7 20.3 pmol/L. The prevalence of subclinical hypothyroidism in the 503 pregnant women was 16.9% according to the diagnostic criteria of TSH 2.5 mIU / L and 3.8% using our calculated reference interval. Hypothyroxinemia was registered in 5,3% using reference values recommended by diagnostic tests manufacturer and in 2,8% according to our calculated reference interval for fT4. GDM was diagnosed in 23% of women. Logistic regression analysis showed associations of hypothyroxinemia and TPO-Ab-positivity with the increased risk of GDM that remained significant after adjustments on age and body mass index (BMI) [adjusted OR (95% CI) = 7.39 (1.2742.93) for hypothyroxinemia, p=0.026; and adjusted OR (95% CI) = 2.02 (1.014.04) for TPO-Ab-positivity, p=0.047). Conclusions. Reference intervals for first trimester TSH and fT4 have been established for pregnant women living in St. Petersburg. Hypothyroxinemia and TPO-Ab-positivity were associated with the increased risk of GDM.

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