Obstetric Outcomes of an Afro - Caribbean Cohort Following Universal Screening and Treatment of Subclinical Hypothyroidism

2015 ◽  
Author(s):  
N Johnson ◽  
A-K Taylor-Christmas ◽  
V Chatrani ◽  
E Choo-Kang ◽  
M Smikle ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Obstetric Outcomes

scholarly journals Do we need to screen and treat pregnant women for subclinical hypothyroidism? A cross sectional study in a rural tertiary centre in Kerala, India

2017 ◽  
Vol 6 (3) ◽  
pp. 781
Author(s):  
Radha K. R. ◽  
Nishu Sugunan ◽  
Resmy C. R.
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

Background: Hypothyroidism (HT) is associated with maternal and perinatal morbidity. Subclinical HT rather than overt occur in pregnancy, because overt HT causes infertility. Treatment of overt HT was beneficial in reducing the fetal and maternal complications, Usefulness of correcting subclinical hypothyroidism was doubtful, hence Universal screening of pregnant women was not recommended.Methods: Cross sectional study, conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur, Kerala, India. 50 consecutive cases of subclinical hypothyroidism in pregnancy were analyzed for Thyroid function, antenatal, natal, postnatal complications. Perinatal complications, including neonatal hypothyroidism also noted. Statistical analysis done using computer software Epi info3.4. Data expressed in its frequency and percentage, continuous data in mean.Results: All women in the study group received levothyroxine during pregnancy from time of diagnosis. At the time of delivery 84% women were euthyroid and 16% hypothyroid. Complications like anemia 36%, abruption 4%, and postpartum hemorrhage 6% showed a statistically significant association, while pre-eclampsia 20%, preterm labor 22% had no statistically significant association. Comparing the women who are euthyroid as a result of levothyroxine supplementation to women inadequately treated, complications like anemia (33% versus 50%, p value 0.042), abruption (0% versus 4%, p value0.023), PPH (2% versus 6%, p value 0.014) were significantly less in well controlled.Conclusions: Significant association was noted between inadequately treated hypothyroidism and maternal complications like anaemia, placental abruption, placenta previa, PPH, preterm delivery, and caesarean section rate for foetal distress. Universal screening of pregnant women for thyroid status is recommended.

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.

scholarly journals A hospital based retrospective study of thyroid disorders on obstetric and perinatal outcomes

2020 ◽  
Vol 9 (11) ◽  
pp. 4590
Author(s):  
Sagar R. Patel ◽  
Pushpa A. Yadava ◽  
Shital T. Mehta ◽  
Bina M. Raval ◽  
Viditsinh P. Sisodiya ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
First Trimester ◽  
Adverse Outcomes ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Free T4

Background: The study was undertaken in pregnant women to understand and analyze the obstetric and foetal outcomes of thyroid disorders.Methods: TSH estimation was used as universal screening in their first visit to our hospital. Those patients with abnormal TSH values, i.e. above 2.5 mIU/ml in first trimester and above 3 mIU/ml in second and third trimesters were evaluated for free T3, free T4 and TPO Abs. They were treated accordingly and dosage adjustments made and the tests repeated once in 4-6 weeks. They were followed throughout pregnancy and delivery.Results: Total no of pregnant women screened were 904 over a period of 1 year from 15 March 2019 to 14 March 2020, of which 115 had abnormal thyroid functions, thereby the prevalence of thyroid disorders being 12.72%. Of the 115 patients with thyroid disorders, 112 were hypothyroid and 3 were hyperthyroid. Among the 112 hypothyroid cases, 48 were known cases and 64 were new cases. The total cases of subclinical hypothyroidism were 88, prevalence being 9.73% and overt cases were 24, prevalence being 2.65%; 3 cases were overt hyperthyroid, prevalence being 0.33%. 66% of subclinical hypothyroidism were TPO positive and 34% of overt hypothyroidism were TPO positive (p<0.05). Out of 115 abnormal thyroid function patients, 92 patients delivered in our hospital. There were 15 abortions, 13 spontaneous and 2 terminations of pregnancies; 7 patients have delivered outside and 1 patient lost follow up.Conclusions: The prevalence of thyroid disorders during pregnancy was significantly more in our study, hypothyroidism being the commonest. Significant numbers of cases were newly diagnosed on universal screening. The commonest disorder was subclinical hypothyroidism. Adverse maternal and foetal outcomes were almost similar in both subclinical and overt hypothyroidism. The common adverse outcomes noted were abortions, pre-eclampsia, gestational diabetes mellitus, preterm births and increased rates of caesarean sections. The adverse outcomes were significantly more in autoimmune antibody positive patients.

scholarly journals Thyroid autoimmunity and obstetric outcomes in women with recurrent miscarriage: a case–control study

2013 ◽  
Vol 2 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Kusum Lata ◽  
Pinaki Dutta ◽  
Subbiah Sridhar ◽  
Minakshi Rohilla ◽  
Anand Srinivasan ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Recurrent Miscarriage ◽  
Thyroid Autoimmunity ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
Thyroid Peroxidase ◽  
Antibody Positivity ◽  
History Of ◽  
Design And Methods

ObjectivesThyroid antibody positivity during pregnancy has been associated with adverse outcomes including miscarriage and preterm delivery. The aim of the study is to evaluate the obstetric outcome in pregnant women with recurrent miscarriage and their response to levothyroxine (l-T4) therapy.Study design and methodsAll pregnant and non-pregnant women between 21 and 35 years of age with a history of two or more consecutive miscarriages were included in the study. A third group comprising 100 pregnant women without a history of miscarriage were taken as healthy controls. Thyroid autoimmunity, prevalence of subclinical hypothyroidism and maternal and foetal complications were analysed in all the groups with appropriate statistical methods.ResultsThe mean age of the patients included in the study was 27.0±3.1 years. Of 100 pregnant patients with previous recurrent miscarriage, thyroid autoimmunity (thyroid peroxidase antibody (TPOAb+) >34 U/ml) was found in 31% of the cases. The incidence of subclinical hypothyroidism was higher in TPOAb+ group than in TPOAb− group (52 vs 16%; P=0.0002). There was no difference in the prevalence of miscarriage or obstetric outcomes between recurrent miscarriage and healthy pregnant women group irrespective of TPO status.ConclusionsThe prevalence of thyroid autoimmunity was higher in pregnant women with a history of recurrent abortion compared with healthy pregnant control population. Following l-T4 treatment, there was no difference in prevalence of miscarriage between hypothyroid and euthyroid individuals in TPOAb+ women.

Subclinical hypothyroidism: Is there a benefit to treatment?

2008 ◽  
Vol 41 (21) ◽  
pp. 9
Author(s):  
HOSSEIN GHARIB ◽  
Douglas Ross
Keyword(s):  
Subclinical Hypothyroidism
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