scholarly journals Frequency of subclinical hypothyroidism and mean serum TSH level in first trimester of pregnancy.

2021 ◽  
Vol 28 (12) ◽  
pp. 1763-1767
Author(s):  
Fouzia Perveen ◽  
Lubna Ali ◽  
Afshan Hasan

Objective: To find out the frequency of subclinical hypothyroidism (SCH) in our pregnant population during 1st Trimester and the mean TSH level in first trimester of pregnancy. Study Design: Cross Sectional Descriptive study. Setting: Dow University Hospital and Dr Ruth KM Pfau CHK. Period: June 2015 to May 2016. Material & Methods: All Pregnant women with <14 weeks gestation were screened for Serum TSH level. Data were recorded after informed consent and institutional ethical approval. Variables recorded were age, parity, gestational age and serum TSH level. Data were analyzed on SPSS version 16. Mean and SD were calculated for quantitative variables ie. Age, parity, gestational age, serum TSH level and serum free T4 level. Mean TSH level according to age group, parity and gestational age groups were determined by applying ANOVA test. Correlation of Serum TSH level with the maternal age, parity and gestational age groups were also assessed by Pearson Correlation test. Significant P-value was taken as <0.05. Results: The frequency of SCH found was 19.35% by taking cut off limit of <2.5 IU/L and 3.55% by taking cut off limit of <4.5 IU/L among total of 310 pregnant women. Mean TSH level was 1.84±1.36 IU/L. The mean maternal age was 27.22 ± 4.43 yrs. while median parity was 1. Mean gestational age of these patients were 9.41 ± 2.748 weeks and out of these 160 (51.61%) were between 4-9 weeks and 150(48.38%) between 10-14 weeks. Majority (74%) of these women belonged to lower middle socioeconomic class. Mean TSH level coorelation between different age groups, parity groups and gestational age groups were found to be insignificant. Conclusion: The prevalence of SCH is not so high and mean TSH level in our population was 1.84 IU/L. But to establish reference range for Pakistani population, further studies in population of different backgrounds and geographical distribution needs to be evaluated.

Author(s):  
Shripad Hebbar ◽  
Sahan Kumar ◽  
Sapna Amin ◽  
Sneha Doizode

Objective: To find the prevalence of subclinical hypothyroidism in the first trimester of pregnancy and to compare the maternal and perinatal outcome in them with euthyroid mothers.Methods: The present study was a prospective observational case-control study done in a tertiary hospital over the period of one and half years. Pregnant women in the first trimester of pregnancy were tested for Thyroid Stimulating Hormone (TSH) levels and those who had TSH>2.5mIU/l, free T3 and free T4 estimation was carried out on the same sample. A total of 171 women could be followed up till delivery and their first-trimester thyroid profile was available for analysis. They were grouped into two groups, Group 1: all women with TSH level>2.5 mIU/l, considered to be hypothyroid (n=79), Group 2: women with euthyroid status with TSH levels 0.1 to 2.5 mIU/l (n=95). All the neonates delivered in the first group had cord blood TSH estimation.Results: In the study period, there were 2632 deliveries. The number of pregnant women with first trimester TSH levels>2.5 mIU/l were 79, giving the prevalence rate of 3 % for subclinical hypothyroidism during pregnancy. The obstetric complications observed were gestational hypertension 3.8%, gestational diabetes 6.3%, placenta praevia1.3% and preterm delivery 7.6%. The perinatal complications included Intrauterine growth restriction (IUGR) 1.3%, Low Birth Weight (LBW) 3.8%, perinatal asphyxia 2.5% and neonatal hypothyroidism 1.3%. Only preterm delivery appeared to be significantly associated with subclinical hypothyroidism.Conclusion: The observed complication rates were much similar, in fact, lesser with gestational diabetes, pregnancy hypertension, IUGR, LBW compared to global and Indian prevalence rates. This indicates that the cut-off for diagnosing subclinical hypothyroidism should be derived from TSH assays from the local geographic population and should guide the treating physician to establish appropriate TSH ranges where definite therapeutic intervention is required to improve the maternal and foetal outcome.


Author(s):  
Wendy Chinwe Oliobi ◽  
Johnbosco Ifunanya Nwafor ◽  
Arinze Chidiebere Ikeotuonye ◽  
Nnenna Assumpta Nweke ◽  
Bridget Nkiruka Uche Nwidagu ◽  
...  

Background: Antenatal care is a core component of safe motherhood initiative and it helps indirectly in reducing maternal and perinatal morbidity and mortality. Despite the obvious benefits of antenatal care, utilization of this service is very poor in our environment. Therefore, this study sought to assess the gestational age at booking, the reason for booking and determine the factors responsible for late booking among antenatal attendees at the Alex Ekwueme Federal University Teaching Hospital Abakaliki.Methods: This was a cross-sectional descriptive study conducted 5th May 2016 and 10th June 2016 among 258 consecutive pregnant women who presented for booking at the antenatal clinic of the hospital, using self-administered, pre-tested questionnaires. Statistical analysis was done using Epi Info 7.2.1.Results: The mean gestational age at booking was 21.5±4.8 weeks. The mean age of the respondents was 28.2±3.8 years while the mean parity was 1.5±1.6 years. Most of the women booked after the first trimester of pregnancy, only 61(24.8%) of the respondents booked in the first trimester of pregnancy. Majority of the women had no problem at booking 36.7%. Women aged 20-34 years booked late compared to women aged less than 20 years and those above 34 years and the difference was statistically significant. There was no statistically significant difference in maternal parity, education, marital status and religion with regards timing of booking. However, women who were sick during the first trimester were more likely to book early as well as women who booked early in their previous pregnancy.Conclusions: Late booking was common in our environment. There is an urgent need for increase awareness of the benefits of early booking to pregnancy outcome.


2021 ◽  
Vol 15 (8) ◽  
pp. 1855-1857
Author(s):  
Israr-Ul- Haq ◽  
Junaid Mushtaq ◽  
Atiq Ahmad ◽  
Waqas Mahmood ◽  
Mujtaba Hasan Siddiqui ◽  
...  

Aim: To evaluate and assess the prevalence along with its related complications of subclinical hypothyroidism in pregnant ladies during the 1st trimester of pregnancy in Pakistani population. Study design: Cross sectional study Place and duration of study: Department of Medicine, Unit-1 of Lahore General Hospital, Lahore, Pakistan from 11th February 2019 to 29th December 2019. Methodology: Four hundred and fifty seven pregnant women with a gestational age up to 12th week with an age group between 18-45 years were included in this study. Blood samples were collected for free triiodothyronine, free thyroxine and thyroid stimulating hormone levels. Patients were regularly followed at an interval of 4 weeks for their entire pregnancy period. Adverse events and complications were noted. Results: One hundred and sixty nine subjects had TSH levels above the normal range i.e., 4.6-10mIU/L. 288 subjects were having TSH below 4 mIU/L levels. The overall prevalence of subclinical hypothyroidism (SCH) was found to be 37% in pregnant women during their first trimester of pregnancy. Pregnant women having subclinical hypothyroidism (SCH) were having higher risks of loss of pregnancy, abruptio placentae and neonatal death rates as compared to euthyroid pregnant women. Conclusion: Higher prevalence of subclinical hypothyroidism (SCH) in the first trimester of pregnancy indicates that these women are at increased risks of loss of pregnancy, placental abruption and neonatal death as compared to euthyroid pregnant women. Keywords: First trimester; pregnancy; subclinical hypothyroidism


2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Cécilia Légaré ◽  
Andrée-Anne Clément ◽  
Véronique Desgagné ◽  
Kathrine Thibeault ◽  
Frédérique White ◽  
...  

Abstract Background During pregnancy, maternal metabolism undergoes substantial changes to support the developing fetus. Such changes are finely regulated by different mechanisms carried out by effectors such as microRNAs (miRNAs). These small non-coding RNAs regulate numerous biological functions, mostly through post-transcriptional repression of gene expression. miRNAs are also secreted in circulation by numerous organs, such as the placenta. However, the complete plasmatic microtranscriptome of pregnant women has still not been fully described, although some miRNA clusters from the chromosome 14 (C14MC) and the chromosome 19 (C19MC and miR-371-3 cluster) have been proposed as being specific to pregnancy. Our aims were thus to describe the plasma microtranscriptome during the first trimester of pregnancy, by assessing the differences with non-pregnant women, and how it varies between the 4th and the 16th week of pregnancy. Methods Plasmatic miRNAs from 436 pregnant (gestational week 4 to 16) and 15 non-pregnant women were quantified using Illumina HiSeq next-generation sequencing platform. Differentially abundant miRNAs were identified using DESeq2 package (FDR q-value ≤ 0.05) and their targeted biological pathways were assessed with DIANA-miRpath. Results A total of 2101 miRNAs were detected, of which 191 were differentially abundant (fold change < 0.05 or > 2, FDR q-value ≤ 0.05) between pregnant and non-pregnant women. Of these, 100 miRNAs were less and 91 miRNAs were more abundant in pregnant women. Additionally, the abundance of 57 miRNAs varied according to gestational age at first trimester, of which 47 were positively and 10 were negatively associated with advancing gestational age. miRNAs from the C19MC were positively associated with both pregnancy and gestational age variation during the first trimester. Biological pathway analysis revealed that these 191 (pregnancy-specific) and 57 (gestational age markers) miRNAs targeted genes involved in fatty acid metabolism, ECM-receptor interaction and TGF-beta signaling pathways. Conclusion We have identified circulating miRNAs specific to pregnancy and/or that varied with gestational age in first trimester. These miRNAs target biological pathways involved in lipid metabolism as well as placenta and embryo development, suggesting a contribution to the maternal metabolic adaptation to pregnancy and fetal growth.


Author(s):  
І. Yu. Kostyuk ◽  
G. V. Chayka ◽  
M. S. Storozhuk ◽  
О.К. Таrаsiuk

One of the most important problems of modern urogynecology is the improvement of the treatment-diagnostic algorithm and prevention of overactive bladder syndrome (OAB). The purpose of the work is to construct and analyze discriminant models of the possibility of OAB occurrence in pregnant women of different age groups depending on the characteristics of anthropo-somatotypological indicators or hormonal background. 75 pregnant women with clinical signs of OAB syndrome and 60 healthy pregnant women had hormonal screening in the 1st and 3rd trimester of pregnancy and at 16 weeks postpartum using radioimmunoassay and immune enzyme methods (estradiol, progesterone, thyroid stimulating hormone and testosterone levels were determined). The anthropometry was carried out according to the method of V. V. Bunak, the components of the somatotype were determined according to the method of J. Carter and B. Heath, as well as the components of the body composition according to the method of J. Matiegka and the American Institute of Nutrition (AIN). By age, all pregnant women were divided into 3 subgroups: І - from 17 to 25 years, ІІ - from 26 to 35 years, ІІІ - from 36 to 41 years. A discriminant analysis of the possibility of OAB occurrence, depending on the anthropo-somatotypological or hormonal indices in women of different age groups, was conducted using the licensing program “Statistica 5.5”. When taken into account anthropo-somatotypological indices in women aged from 17 to 25 years, the model is correct in 86.7% of cases; in women aged from 26 to 35 years - in 90.9% of cases; in women between the ages of 36 and 41 years - in 89.3% of cases. Between healthy and OAB patients, women aged from 17 to 25 years discriminating variables are the width of the distal epiphysis of the shoulder (which has the greatest contribution to discrimination), conjugata externa, the muscle component of the body weight by AIN and the forearm's girth in the upper third; women from 26 to 35 years - dist. Іntеrtrochantericа, the width of the distal epiphyses of the forearm (the greatest contribution to discrimination), hip circumference, conjugata externa, mesomorphic component of the somatotype according to by Heath-Carter, fat mass component of the body by Matiegka, the forearm's girth in the upper third and the shoulder girth; women of age from 36 to 41 years - the width of the distal epiphysis of the leg (which has the greatest contribution to discrimination) and the length of the body. In general, the aggregate of all variables has a low level of discrimination between healthy and sick with OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.531; F = 5.521; p <0.01) and 36-41 years (Wilkes Lambda statistics = 0.445; F = 15.62; p <0.001), while among women between the ages of 26 and 35 - the average level of discrimination (Wilkes Lambda statistics = 0.386; F = 13.52; p <0.001). When taken into account characteristics of the hormonal background in women of all ages, the model is correct in 100% of cases. Between healthy and OAB patients, of 17-25 years age, discriminant variables are estradiol levels at 16 weeks of postpartum (with the largest contribution to discrimination) and prolactin levels in the first trimester of pregnancy; women aged from 26 to 35 years - estradiol levels at 16 weeks of postpartum (the most contributing to discrimination), testosterone in the third trimester of pregnancy, estradiol in the third trimester of pregnancy, prolactin in the third trimester of pregnancy, estradiol in the first trimester of pregnancy, and testosterone levels in the first trimester of pregnancy; women aged from 36 to 41 years - estradiol in the third trimester of pregnancy (has the largest contribution to discrimination) and estradiol in the 16 weeks of postpartum period. In general, the totality of all variables has a low level of discrimination between healthy and sick at OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.619; F = 131.4; p <0.001) and ages 26-35 (Wilks Lambda statistics = 0.493; F = 224.9; p <0.001), while among women between the ages of 36 and 41 - the average level of discrimination (Wilkes Lambda statistics = 0.371; F = 207.4; p <0.001). Thus, with the aid of discriminant analysis, reliable models of the possibility of OAB occurrence, based on anthropo-somatotypological or hormonal indices in women of different age groups, are constructed. In all age groups, the greatest contribution to discrimination between healthy and sick with OAB pregnant women, in most cases, make parameters of the width of distal epiphyses of long limb bones or the level of estradiol.


2020 ◽  
Vol 7 (2) ◽  
pp. 419-424
Author(s):  
Buğra Çoşkun ◽  
Bora Çoşkun ◽  
Özge Şehirli Kıncı ◽  
Coşkun Şimşir ◽  
Ramazan Erda Pay ◽  
...  

Objective:  Investigation of the thyroid function test (fT3, fT4 and TSH) results and the prevalence of overt/subclinical hypothyroidism according to age groups in patients who had applied to our hospital and diagnosed with pregnancy. Material and Methods: Two thousand nine hundred and thirty-six women diagnosed with pregnancy for the first time upon seeing the fetal heartbeats with ultrasonography between January 2015 and December 2018, were included in our study. Patients were divided into 5 age groups, namely, the age groups of ≤18 years of age, 19-25 years, 26-35 years, 36-45 years and >45 years of age. The fT3, fT4 and TSH levels were statistically compared between all the patients and age groups. Results: Two thousand nine hundred and thirty-six pregnant women were included in the study. The mean fT3 value was found as 3.180±0.519 (pg/mL), fT4 value as 1.051±0.258 (ng/d/L) and TSH value was found as 2.000±1.595 (mIU/mL) in all the population. The mean fT3, fT4 and TSH values were not statically different among the age groups (p=0.06, p=0.08 and p=0.829, respectively). No statistically significant differences were found among all the age groups as regards hyperthyroidism, euthyroidism, subclinical hypothyroidism and overt hypothyroidism (p=0.200). Conclusion: Consistently with the previous studies in our country, the prevalence of subclinical hypothyroidism was found as high as 22.7% in our study. We think that scanning for hypothyroidism must be performed in the pregnancy period without discriminating between risk groups in our country, which is located in the iodine deficiency region. However, considering the different age groups, we believe that TSH levels must be measured with the same apprehensiveness for each age group since no statistically significant differences are found between age groups.


2020 ◽  
Vol 27 (11) ◽  
pp. 2474-2477
Author(s):  
Kashif Ali Khan ◽  
Muhammad Saleem Akhter ◽  
Kehkashan Fatima ◽  
Muhammad Waqar Saleem

Objectives: The prime objective of this study was to evaluate and asses the prevalence and related complications of SCH in pregnant ladies in their 1st trimester of pregnancy in Pakistani population. Study Design: Cross Sectional study. Setting: Department of Medicine, Teaching Hospital, DG Khan, Pakistan. Period: 11th February 2017 to 29th December 2018. Material & Methods: We obtained informed consent from all patients. 457 pregnant ladies having last missed period till 12th week with age group between 18-45 years were included in this study. Samples were collected for T4 (Thyroxine), TSH (Thyroid Stimulating Hormone) and T3 (Triiodothyronine). Patients were followed for their entire pregnancy period.  Adverse events and complications were noted. Results: Out of 457 patients who were included in our study, 169 subjects had TSH levels well above 4.6- 10 mIU/L. 288 subjects were having TSH levels below 4 mIU/L. The overall prevalence of subclinical hypothyroidism (SCH) was found to be 37% in pregnant women during their first trimester of pregnancy. Pregnant women having subclinical hypothyroidism (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. Conclusion: Our study concludes that overall prevalence of subclinical hypothyroidism (SCH) in Pakistani pregnant women during their first trimester of pregnancy was found to be 37%. Pregnant women having subclinical hypothyroidisms (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. In the light of these findings we recommend routine screening for TSH, free T3 and free T4 during pregnancy especially during 1st trimester of pregnancy.


2020 ◽  
Vol 8 (11) ◽  
pp. 204-210
Author(s):  
Asmita Mahato ◽  
Barsha Shrestha

Background: The incidence of pregnancy complications may be due to risk factors during pregnancy. Whether maternal parameters like age, gravida/ parity, gestational age, and fetal heart rate have any influence to the delivery outcome and newborn weight is a big quest. A young age at birth is more common in Nepal and carries a less social stigma, and hence enforces this study to understand the impact. Objective and methodology: The objectives of this retrospective study were to evaluate the maternal and prenatal outcomes of pregnancies and the effects of the age of the pregnancy, gravida, gestational age, and newborn weight. Pregnant women giving birth in Rangeli Hospital, Morang (Nepal) in 2019 were retrospectively screened. Pregnant women of all age group were included in this study. Results: Mean maternal age for delivery of child was 22.45 ±0.225 years. 41.9% of study subjects were primigravida (G1), while 58.1% were multi-gravida (G2-4). The mean age of primigravida is 20.57 ±0.025 years. Mean gestational week, fetal heart rate (FHR), and newborn weight were 38.18 ±0.11, 140.91 ±0.43, and 2870.65 ±26.13 g respectively. Almost one-third (32.1%) of the newborn were preterm babies. 20.9% of the newborn child was low birth weight. Spontaneous vaginal delivery was seen in 90.7% of the pregnancy while 7.9% had caesarean section. Conclusion: A significant positive correlation was seen of age with gravida, parity, and newborn weight. Newborn weight was significantly related to gestational age. There is no significant difference between the mean maternal age of mother delivering preterm baby or term-baby. No significant difference in the mean age of the mother or the mean gestational duration between male and female children could be established. Significant mean differences were seen in the maternal age of LBW child and normal birth weight child.


2017 ◽  
Vol 06 (03) ◽  
pp. 179-183
Author(s):  
Shahin Kazi ◽  
Harsha A. Keche ◽  

Abstract Background : Approximately 15% of all clinically recognized pregnancies end in spontaneous abortions. Chromosomal disorders are responsible for 50% of the spontaneous abortions. Most commonly it occurs in the first trimester of pregnancy. Aim : To study the cytogenetic analysis of chorion villous tissue in 50 cases of abortion in age groups of 19-40 years. Material and Methods : Cytogenetic analysis was performed by implementing standard protocol of planting, harvesting, banding and screening. The karyotypes were prepared and observed under microscope. Statistical analysis was done by calculating the percentage of abnormal abortions in relation to maternal age. Results : It was observed that maximum abortion took place between 25-34 years of maternal age. The rate of abortion with trisomy was maximum followed by polyploidy and monosomy. It was seen that rate of abortion with monosomy decreases with increase in maternal age. Contrary to this trisomy increased with increase in maternal age. Conclusion : Cytogenetic study revealed that the rate of trisomie abortions increased with the increase in maternal age.


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