Association of Thyroid Dysfunction and Pregnancy Outcomes

2021 ◽  
Vol 15 (12) ◽  
pp. 3367-3369
Author(s):  
Nagina Bibi ◽  
Iram Inam ◽  
Ghiasul Hassan
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Thyroid Dysfunction ◽  
Adverse Outcomes ◽  
Common Finding ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Thyroid Disorder ◽  
Singleton Pregnancy ◽  
In Pregnancy

Background: Hypothyroidism in pregnancy results in serious consequences for both mother and fetus. Pregnant women are prone to thyroid dysfunction due to physiological changes taking place in body. This study is undertaken to see the effect of thyroid dysfunction on pregnancy outcomes. Methodology: A prospective observational study was done. Study was conducted in a private gynecological and obstetric unit. A sample size of 200 women in selected institute with singleton pregnancy was recruited. Pregnant women with chronic disabilities and previously known thyroid disorders were excluded. Data was analyzed using SPSS version 23.0 and binary logistic regression analysis was done. Ethical rules were followed throughout the study and consent taken from all participants. Results: Out of 200, 23 participants were positive for thyroid disorder. Thyroid dysfunctions are responsible for causing multiple complications in pregnancy for mother and fetus. Findings suggest a signification association of thyroid dysfunction and feto-maternal consequences (p-value <0.005). Conclusion: Subclinical hypothyroidism is a common finding during pregnancy. It is compulsory to detect and treat thyroid dysfunction early in pregnancy so that adverse outcomes could be avoided. There is a need for timely screening of thyroid profile in suspected pregnancies. keywords: TSH, FT3, FT4, Pregnancy, Outcomes.

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.

AN EPIDEMIOLOGICAL STUDY ON THE PREVALENCE OF HYPOTHYROIDISM IN PREGNANT WOMEN AND ITS OUTCOME

2021 ◽  
pp. 48-50
Author(s):  
Vinita singh ◽  
Sneha kumari
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Neonatal Outcome ◽  
Reproductive Age ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Thyroid Disorder ◽  
Neonatal Complications ◽  
In Pregnancy

Thyroid disorders are the most common endocrine disorders affecting women of reproductive age group Hypothyroidism is common in pregnancy with an estimated prevalence of 2-3% Maternal hypothyroidism leads to many maternal and perinatal complications like miscarriage, gestational diabetes mellitus, pre-eclampsia, pre-term labor, placental abruption, and fetal death. AIMS AND OBJECTIVE: To nd out the effect of hypothyroidism on the course of pregnancy, to study the neonatal outcome, to know the prevalence of subclinical and overt hypothyroidism in pregnant women. MATERIALS AND METHODS: This prospective study was conducted in the department of Obstetrics and Gynecology, Nalanda medical college and hospital, Patna. All pregnant women attending the obstetric unit during this period were included in the study after informed consent 10 ml of blood sample of pregnant women was drawn at the rst visit in the rst trimester; then it was centrifuged and stored at -70 degree Celsius until assays, which were done after delivery, TFT was assessed by quantitative analysis of serum TSH and FT4 (ELISA). The pregnancy outcome variables like miscarriages, preterm deliveries, IUGR, preeclampsia, anemia, low birth weight, intrauterine fetal demise, antepartum hemorrhage, stillbirth, postpartum hemorrhage, birth asphyxia were studied. The neonatal outcome was also studied. The statistical analysis was done using the odds ratio. P-value <0.05 was considered signicant. RESULTS: Out of the 250 pregnant women 25 had hypothyroidism (9.5%). The prevalence of subclinical hypothyroidism was more as compared to the overtone (Table 2). Abortions were seen in 12.5% of subclinical and 11.1% of overt hypothyroid women. PIH and abruptions were signicantly higher in subclinical cases (P<0.05) while in the overt group both complications were higher as compared to the normal women but the p-value was not signicant for abruption. More of the hypothyroid women had preterm delivery (37.5% in subclinical and 44.4% in the overt group), Regarding neonatal complications, IUD and Early neonatal deaths were signicantly higher in overt hypothyroidism (P<0.01) Hypothyroid women had more low birth weight babies (31.25% in subclinical and 35.5% in overt) and IUGR babies (18.70% in subclinical and 22.21% in overt), CONCLUSION: The present study shows that, though the occurrence of hypothyroidism in pregnancy is less yet it causes many maternal and neonatal complications therefore universal screening of thyroid disorder should be done in pregnancy.

scholarly journals The study of maternal and fetal outcome in pregnant women with thyroid disorders

2017 ◽  
Vol 6 (8) ◽  
pp. 3507 ◽  
Author(s):  
Sreelatha S. ◽  
Seema Nadagoudar ◽  
Asha Devi L.
Keyword(s):  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Post Partum ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Endocrine Disorders ◽  
Thyroid Disorders ◽  
Thyroid Disorder ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

Background: Thyroid disorders are among the common endocrine disorders in pregnant women after diabetes mellitus. Several changes are observed in maternal thyroid function during pregnancy and failure to adapt to these physiological changes results in thyroid dysfunction. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effect on mother and the fetus, like miscarriages, preterm delivery, preeclampsia, eclampsia, polihydromnios, placental abruption, post-partum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorders on pregnancy and its maternal and the fetal outcome.Methods: The present study was conducted in ESI Hospital Rajaji Nagar, Bangalore. It is a prospective study which involved 100 patients diagnosed to have thyroid disorder during their antenatal checkup in the first trimister. It also includes known cases of thyroid disorder. TSH level was estimated. If it is deranged, then FT3 and FT4 levels estimated. Patients were managed accordingly and followed till delivery. Their obstetric and perinatal outcomes were noted.Results: In our study out of 100 cases, 96 cases are subclinical hypohyroid and 4 cases are subclinical hyperthyroid. Subclinical hypothyroidism in pregnancy are associated with abortions (2.1%), Anaemia (4.20%), PIH (14.7%), GDM (4.2%), Preterm labour (3.1%), oligohydromnios (16.67%), Lscs (22.9%), PPH (6.3%), LBW (21.9%), Hyperbilirubinemia (9.4%), NICU admission (14.6%), Which are co-relatine with other studies and hyperthyroid cases in our study were not sufficient for outcome analysis.Conclusions: Thyroid disorders in pregnancy have adverse effects on maternal and fetal outcome emphasizing the importance of routine antenatal thyroid screening.

scholarly journals Prevalence of thyroid dysfunctions in pregnant women: a prospective study in a tertiary care hospital in Maharashtra, India

2018 ◽  
Vol 7 (8) ◽  
pp. 3211
Author(s):  
Vaishali R. Korde ◽  
Sharin P. Barse ◽  
Jaya S. Barla
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Total Sample ◽  
Adverse Outcomes ◽  
Sample Population ◽  
Care Hospital ◽  
A Prospective Study ◽  
In Pregnancy

Background: Thyroid dysfunction is known to be the commonest endocrinological disorder in pregnancy. A range of adverse outcomes in pregnant women and the fetus have been reported. These can be prevented if the thyroid dysfunction is diagnosed and treated as early as possible. There are limited studies conducted on the prevalence of thyroid dysfunction in pregnancy in India. Hence, this study was conducted for assessment of the prevalence of thyroid dysfunction in pregnancy.Methods: The present study is a prospective study conducted in the Department of Obstetrics and Gynecology, MIMER Medical College and Hospital, Talegaon, Dabhade, Maharashtra. The total sample population comprised of 705 pregnant women with uncomplicated singleton intra-uterine pregnancy. All participants were screened by estimation for serum TSH in first trimester.Results: The prevalence of thyroid dysfunction in the present study is 13.9%. Of this, prevalence of hypothyroidism is 12.76% and that of hyperthyroidism is 1.13%.Conclusions: With this study, we conclude that there is high prevalence of thyroid dysfunction in pregnancy even in rural population. Thus, a universal screening helps in early diagnosis and preventing the aftermaths of thyroid dysfunction in pregnancy.

scholarly journals Prevalence of hypothyroidism amongst pregnant women: a study done in rural set up

2018 ◽  
Vol 7 (4) ◽  
pp. 1586 ◽  
Author(s):  
Nancy S. Pillai ◽  
Jemela Bennet
Keyword(s):  
Thyroid Hormone ◽  
Pregnant Women ◽  
Intellectual Development ◽  
Thyroid Dysfunction ◽  
First Trimester ◽  
Reproductive Age ◽  
Overt Hypothyroidism ◽  
Endocrine Disorders ◽  
Thyroid Disorder ◽  
In Pregnancy

Background: Thyroid disorders are the commonest endocrine disorders affecting women of reproductive age group. The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. During early pregnancy the foetus is totally dependent on maternal thyroid hormone supply. Thyroid hormone is critical for foetal brain and intellectual development and some preventable conditions like abruption, pre-eclampsia etc. which produce morbidity and pose special risk for pregnancy and the developing foetus.Methods: All subjects enrolled in the study as per the inclusion criteria will be subjected to a detailed history and clinical examination using a predesigned proforma. A serum TSH value will be sent in 1st trimester between 6-10 weeks period of gestation for all pregnant women.Results: The prevalence of thyroid dysfunction in pregnancy was 10.8% with hypothyroidism being 9.2%, out of which 8.5% were cases of subclinical hypothyroidism and 0.7% were cases of overt hypothyroidism. On assessing the risk factors for developing thyroid dysfunction in pregnancy, increases in incidence were seen with maternal age and increasing BMI, both of which were statistically significant.Conclusions: This study showed an increased prevalence of hypothyroidism in pregnancy recommending a need for universal screening for all pregnant women in the first trimester itself. This study aims at validating the efficacy of the above-mentioned screening.

scholarly journals The study of maternal and foetal outcome in pregnant women with thyroid disorder

2019 ◽  
Vol 8 (5) ◽  
pp. 1802
Author(s):  
Priya Maurya ◽  
Neeta Chaudhary ◽  
Natasha Tyagi ◽  
M. R. Kural ◽  
Kriti Bhatnagar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Thyroid Peroxidase ◽  
Thyroid Disorder ◽  
Neonatal Hypothyroidism ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Thyroid disorder is one of the most common disorder in pregnancy. Thyroid disorder is known to be associated with abnormal maternal and foetal outcomes and overlooked in pregnant women because of non-specific symptoms and hypermetabolic state of pregnancy of pregnancy. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effects on mother and the foetus like miscarriages, preterm delivery, pre-eclampsia, eclampsia, polyhydramnios, placental abruption, postpartum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorder on pregnancy and its maternal and foetal outcome.Methods: The present study was conducted in Muzaffarnagar Medical College, Uttar Pradesh, India in collaboration of department of Gynecology and Obstetrics and Pediatrics Department. It is a prospective random cross-sectional study done over 400 pregnant women which includes known cases of thyroid disorder. Serum thyroid stimulating hormone (TSH) test was apart from the routine blood sample investigations as per FOGSI-ICOG good clinical practice recommendation. fT3, fT4 and thyroid peroxidase antibody test were done in patients with a deranged TSH value. Patients were followed up till delivery, and their obstetrics and perinatal outcomes were noted and managed.Results: In present study out of 400 cases, 25 cases are hypothyroidism and 16 cases are hyperthyroidism in pregnancy. Out of these 41 patients with thyroid dysfunction, complications associated were abortions (14.63%), maternal anaemia (9.7%), pre-eclampsia (12.2%), preterm labour (9.76%), abruption placenta (4.88%), IUGR (2.4%), Still birth (7.32%). Out of 41 patients with thyroid dysfunction, foetal complications seen were hyperbilirubinemia (12.2%), Foetal distress (4.88%), NICU admission (17.07%) and low birth weight (21.95%).Conclusions: Thyroid disorder in pregnancy have adverse effects on maternal and foetal outcome emphasizing the importance of routine antenatal thyroid screening.

scholarly journals SUN-431 Case Finding Versus Routine Screening of Thyroid Dysfunction in Pregnancy

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ali Ahmed Al Qarni ◽  
Reem Mohammad Alamoudi ◽  
Khalida Shahid ◽  
Amal Almanei ◽  
Muneera Alotaibi ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Case Finding ◽  
P Value ◽  
Chi Square ◽  
Saudi Women ◽  
In Pregnancy ◽  
High Risk Case

Abstract Background: Thyroid dysfunction in pregnancy is associated several adverse outcomes. This has triggered a debate about whether universal screening should be implemented. Despite recommendations against universal screening, the clinical practice of many caregivers may differ. We aimed to assess the sensitivity of using targeted high-risk case finding for diagnosing thyroid dysfunction in pregnancy compared to routine screening in pregnant Saudi women, and to evaluate if gestational diabetes (GDM) specifically affected the risk. Methods: A cross-sectional study in two hospitals under the Ministry of National Guards Health affairs of Saudi Arabia; King Abdulaziz Hospital, Al-Ahsa, and Imam Abdulrahman bin Faisal Hospital, Dammam. Pregnant ladies attending the Family medicine, Obstetrics and Gynecology, and Endocrinology clinics in both hospitals were assessed by the caring physician based on a check list for risk stratification for thyroid dysfunction as per the 2012 Endocrine society clinical practice guidelines for management of thyroid dysfunction in pregnancy. Presence of one risk factor defined high risk. All patients had a routine serum TSH measured as universal screening is commonly practiced in both institutions, the physician doing the risk stratification was not aware of the TSH result. Sensitivity and specificity for the case finding approach was calculated using and abnormal TSH value as the gold standard for presence of thyroid dysfunction. The institutions lab reference TSH 0.35 – 4.94 mIU/L was used as cutoff. Results: 1571 pregnant women were included in the study; mean age 29.3± 6.2 years, 396 (23.5%) were primigravida. The mean TSH value was 1.898 ± 1.459 mlU/L. 1178 (75%) pregnant women had an indication for screening based on presence of at least one risk factor, of which 95 (8.1%) tested abnormal for TSH. 393 women had no risk factors, of which 379 (96.4%) had normal TSH, (Chi square 9.3, p-value 0.002). [Sensitivity 87.2%, (95%CI 79.4% – 92.8%), Specificity 25.9%, (95%CI 23.7% – 28.3%)]. Total abnormal TSH values was 109 (6.9%), 43 were abnormal high (i.e. hypothyroid); of which 40 screened positive by case finding approach [Sensitivity 93.02%, (95%CI 80.9% – 98.5%), Specificity 25.52%, (95%CI 23.4% – 27.8%)]. Moreover, 178 (11.3%) women screened positive for GDM at some stage in pregnancy out of which only 5 (2.8%) had an abnormal TSH value, while of the 1393 pregnant women who screened negative for GDM 1289 (92.5%) had a normal TSH value, (Chi square 5.3, p-value 0.02). [Sensitivity 4.6%, (95%CI 1.5% – 10.4%), Specificity 88.2%, (95%CI 86.4% – 89.8%)]. Conclusion: Targeted high-risk case finding predicts thyroid dysfunction in pregnant Saudi women with high sensitivity supporting its utility in screening our pregnant population. Gestational diabetes is highly prevalent in Saudi women, but does not increase risk of thyroid dysfunction in pregnancy.

scholarly journals Thyroid screening in pregnancy - a compulsory preventive activity

2015 ◽  
Vol 21 (3) ◽  
pp. 151-156
Author(s):  
Olesea Scrinic ◽  
E. Circo
Keyword(s):  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Reference Range ◽  
The Black Sea ◽  
Specific Reference ◽  
Overt Hypothyroidism ◽  
American Thyroid Association ◽  
Thyroid Disorder ◽  
Entire Study ◽  
In Pregnancy

ABSTRACT Obiectives: To assess the prevalence of thyroid dysfunction in a group of pregnant women, originating from Dobrogea region of southeastern Romania, considered to be an area without iodine deficiency, including the Black Sea area. Materials and methods: We enrolled 324 pregnant women in different trimesters of pregnancy. Each case was reviewed by a detailed madical history, clinical examination and by serum dosage of thyroid hormones: TSH, FT4, and the antithyroidperoxidase. They were evaluated by comparison with trimester -specific reference range for TSH recommended by American Thyroid Association, then the results were compared with those obtained using the manufacturers reference range. Abortion rate was also analysed. Results: The prevalence of thyroid dysfunction was different in all the 3 trimesters: subclinical hypothyroidism being the most frequently approx. 24% of all cases; 7% of pregnant women had overt hypothyroidism. Incidence of thyrotoxicosis in entire study cases was approx. 5.5%. The most frecvent thyroid autoimune disorders were Hashimoto thyroiditis: 42 % - I trimester, 26,6% in II trimester and about 12,5 % in III-trimester; Graves disease have an incidence of only 0,9 % (n=3).The difference between reference methods eluded a lower number of cases using manufactures reference range for TSH (P< 0,001), but higher for recommended trimester - specific TSH value, confirming the undervalueted hypothesis. The risk of misclassifying the hypothyroidism is between 3 %-8 %. Conclusion: Necessity for thyroid hormone dosage periodic/trimesterly/ in pregnancy is a preventive measure. The reference values for hormonal dosage requires trimester-specific assessment. The possibility of hormonal disorders during pregnancy is common. The need for specific therapy at diagnosis depends on the nature of hormonal disorder. Further precautions are needed in pregnant women with known autoimmune thyroid disorder or newly diagnosed

scholarly journals Strategies for the prevention of malaria in pregnancy in Indonesia in the COVID-19 pandemic era

2020 ◽  
Vol 7 (7) ◽  
pp. 2862
Author(s):  
Andre Prawira-Putra ◽  
Theda Lukito ◽  
Rukhsana Ahmed
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Adverse Outcomes ◽  
Vulnerable Group ◽  
Public Health Burden ◽  
The Public ◽  
Health Burden ◽  
Infant Morbidity ◽  
Adverse Pregnancy ◽  
In Pregnancy

Malaria is one of the oldest infectious disease that continues to affect annually more than 200 million people globally. Pregnant women are the second most vulnerable group to malaria, besides children. A pregnant woman with malaria risks detrimental harm to herself and to her child resulting in adverse pregnancy outcomes. These adverse outcomes contribute to maternal, neonatal and infant morbidity and mortality. It is essential to protect pregnant women from malaria to improve the public health burden in malaria endemic countries.

scholarly journals Thyroid disorder in antenatal women in sub-himalayan region: a need for universal screening

2017 ◽  
Vol 6 (8) ◽  
pp. 3445
Author(s):  
Swati Dubey ◽  
Anup Pradhan
Keyword(s):  
Gestational Age ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Thyroid Dysfunction ◽  
Fetal Outcome ◽  
Thyroid Disorder ◽  
Singleton Pregnancy ◽  
Adverse Pregnancy ◽  
Pregnant State ◽  
In Pregnancy

Background: Thyroid dysfunction constitutes the second most common endocrine disorder of pregnancy, associated with adverse maternal and fetal outcome and is often overlooked in pregnancy due to their nonspecific symptoms and the hypermetabolic pregnant state. Objective of present study was to establish the prevalence of thyroid dysfunction, study the effects in pregnancy in sub-himalayan population and whether universal screening for thyroid dysfunction is required.Methods: The study was conducted on 200 patients in the age group of 20 to 35 years with a singleton pregnancy and gestational age between 6 to 24 weeks.Results: In the 200 women screened, the prevalence of thyroid dysfunction was found to be 14% with 8% having subclinical hypothyroidism while an equal percentage of 2% having clinical hypothyroidism, subclinical hyperthyroidism and clinical hyperthyroidism. The mean age of patients with subclinical hypothyroidism was 28.6 ± 4.9 years, with thyroid disorder in pregnancy being significantly more common in primigravida. Statistically significant association was found between patients with thyroid dysfunction and abortions, preeclampsia, preterm labor, small for gestational age, low birth weight, and admission to NICU.Conclusions: Prevalence of thyroid dysfunction was found to be high in our study, particularly subclinical hypothyroidism and was associated with adverse pregnancy outcomes; hence, more research is required in the Sub-Himalayan goitre belt to assess the magnitude of the problem and formulate universal screening protocols in this particular subset of the Indian population accordingly.

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