Title: Thyroid Dysfunction and Pregnancy Outcome in Indian Women
Authors: Dr Manisha Chauhan, Dr Saurabh Tomar
DOI: http://dx.doi.org/10.18535/jmscr/v4i3.60
Abstract
Objective: Development of maternal thyroid disorder during early pregnancy can influence the pregnancy outcome and fetal development. There is lack of published reports regarding relation of thyroid dysfunction with pregnancy outcome. The purpose of this study is to estimate the prevalence of thyroid dysfunction during pregnancy and To study the effect of thyroid dysfunction on pregnancy outcome.
Materials and Methods: The study was a prospective study with a sample size of 400 antenatal patients attending OPD and emergency ward. After taking consent, these patients were randomly selected for the study.
Results: The prevelance of thyroid disorders in our study was 12.5%.with subclinical hypothyroidism (7%), overt hypothyroidism (4%),subclinical hyperthyroidism (1%),overt hyper(0.5%).In our study subclinical hypothyroidism was associated with complications like PE(10.7%), AP(3.57%), PTD(10.7%), Severe Anemia (25%), IUGR (3.75%), LBW(10.75%).Overt hypothyroidism was associated with PE(18.7%), AP (6.25%), PTD (12.5%), Severe Anemia (31.25%), IUGR (12.5%), LBW(18.7%).
Conclusion: Prevelance of thyroid disorders especially subclinical hypothyroidism and overt hypothyroidism was high. Significant adverse effect on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.
Key Words: Pre eclampsia (PE),Abruptio placentae (AP),Pre Term Delivery(PTD),Intra Uterine Growth Retardation (IUGR),Low Birth Weight(LBW),Still Birth(SB),Confidence Interval(CI).
References
1. Zadeh-Vakili A, Ramezani Tehrani F, Hashemi S, Amouzegar A, Azizi F. Relationship between Sex Hormone Binding Globulin, Thyroid Stimulating Hormone, Prolactin and Serum Androgens with Metabolic Syndrome Parameters in Iranian Women of Reproductive Age. Diabetes Metabolism . 2012:S:2. Available at: http://dx.doi.org/10.4172/2155-6156.S2-008
2. Ramezani Tehrani F, Aghaee M, Asefzadeh S. The comparison of thyroid function tests in cord blood following cesarean section or vaginal delivery. Int J Endocrinol Metab. 2003;1:22–26.
3. The American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and Postpar-tum. Thyroid. 2011;21:1081–1125.
4. Yamamoto T, Amino N, Tanizawa O, Doi K, Ichihara K, Azukizawa M, et al. Longitudinal study of serum thyroid hormones, chorionic gonadotrophin and thyrotrophin during and after normal pregnancy. Clin Endocrinol (Oxf) 1979; 10:459–468.
5. Glinoer D, de Nayer P, Bourdoux P, Lemone M, Robyn C, van Steirteghem A, et al. Regulation of maternal thyroid function during pregnancy. J Clin Endocrinol Metab. 1990;71:276–287.
6. El Baba KA, Azar ST. Thyroid dysfunction in pregnancy. Int J Gen Med. 2012;5:227–230.
7. Azizi F, Delshad H. Thyroid Derangements in Pregnancy. IJEM. 2014; 15:491–508.
8. Cignini p, Cafà EV, Giorlandino C, Capriglione S, Spata A, Dugo N. Thyroid physiology and common diseases in pregnancy: review of literature. J Prenat Med. 2012;6:64–71.
9. Casey B, Leveno K. Thyroid disease in pregnancy. Obstet Gynecol. 2006;108:1283–1292.
10. Cunningham F, Leveno KJ, Bloom SL, Hauth JC, Rouse Dj, Spong CY. Williams Obstetrics. 23rd Ed.. McGrraw-Hill Companies; 2010.
11. Delshad H, Azizi F. Thyroid and pregnancy. J Med Council Iran. 2008;26:392–408.
12. Banerjee S. Thyroid Disorders in Pregnancy. JAPI. 2011;59:32–34.
13. Glinoer D, Spencer CA. Serum TSH determinations in pregnancy: how, when and why? Nat Rev Endocrinol . 2010;6: 526–529.
14. Lazarus JH. Thyroid function in pregnancy. Br Med Bul. 2011;97:137–148.
15. Ramezani Tehrani F, Tohidi M, Rostami Dovom M, Azizi F. A Population Based Study on the Association of Thyroid Status with Components of the Metabolic Syndrome. Diabete Metab. 2011;2:1–5.
16. Gaberšček S, Zaletel K. Thyroid physiology and autoimmunity in pregnancy and after delivery. Expert Rev Clin Immunol. 2011;7:697–706.
17. Polak M, Le Gac I, Vuillard E, Guibourdenche J, Leger J, Toubert ME, et al. Fetal and neonatal thyroid function in relation to maternal Gravesʼ disease. Best Pract Res Clin Endocrinol Metab. 2004;18:289–302.
18. Peleg D, Cada S, Peleg A, Ben-Ami M. The relationship between maternal serum Thyroid-stimulating immunoglobulin and fetal and neonatal thyrotoxicosis. Obstet Gynecol. 2002;99:1040–1043.
19. Davis LE, Lucas MJ, Hankins GD, Roark ML, Cunningham FG. Thyrotoxicosis complicating pregnancy. Am J Obstet Gynecol. 1989;160:63–70.
20. Casey BM, Dashe JS, Wells CE, McIntire DD, Leveno KJ, Cunningham FG. Subclinical hyperthyroidism and pregnancy outcomes. Obstet Gynecol. 2006;107:337–341.
21. Davis LE, Lucas MJ, Hankins GD, Roark ML, Cunningham FG. Thyrotoxicosis complicating pregnancy. Am J Obstet Gynecol. 1989;160:63–70.