Abstract: Background: Evaluation of thyroid disease in pregnancy is important for gestational maternal health, obstetric outcome, and subsequent development of the child. The following study was undertaken to estimate the prevalence of hypothyroidism in pregnancy, including both overt and subclinical hypothyroidism and its impact on maternal and neonatal outcomes.
Materials & Methods: In 380 women, serum TSH and FT4 estimation was done by the sensitive chemiluminescent method in our hospital laboratory. Based on their TSH and FT4 report they were divided into 3 groups. Group I: pregnant females with overt hypothyroidism. Group II: pregnant females with subclinical hypothyroidism. Group III: pregnant females with Euthyroid status. Maternal and neonatal outcomes was recorded.
Results: Out of 380 women in study group, 341(89.7%) women were euthyroid, 24 (6.2%) had subclinical hypothyroidism and 15 (3.9%) had overt hypothyroidism. The mean FT4 levels among mothers with overt hypothyroidism was 0.47 ng/dl. The mean FT4 levels among mothers with subclinical hypothyroidism was 1.13 ng/dl. The mean FT4 levels euthyroid mothers was 1.13 ng/dl. The mean TSH levels among mothers with overt hypothyroidism was 10.80 ng/dl. The mean TSH levels among mothers with subclinical hypothyroidism was 4.89 ng/dl. The mean TSH levels euthyroid mothers was 1.41 ng/dl. Total 43 (11.3%) mothers developed gestational hypertension. Gestational hypertension was present in 9% Euthyroid mothers, 29.1% mothers with subclinical hypothyroidism and 33.3% mothers with overt hypothyroidism. Pre-eclampsia was present in 7.6% of Euthyroid mothers, 12.5% of mothers with subclinical hypothyroidism and 26.6% of mothers with overt hypothyroidism. Gestational diabetes mellitus was present in 8.2% of Euthyroid mothers, 12.5% of mothers with subclinical hypothyroidism and 33.3% of mothers with overt hypothyroidism. Premature rupture of membranes was present in 10.2% of Euthyroid mothers, 29.2% of mothers with subclinical hypothyroidism and 40% of mothers with overt hypothyroidism. Preterm delivery was present in 12.3% of Euthyroid mothers, 20.8% of mothers with subclinical hypothyroidism and 13.3% of mothers with overt hypothyroidism.
Conclusion: A high prevalence of subclinical and overt hypothyroidism in pregnant women, with the prevalence of subclinical hypothyroidism being 6.4% and overt hypothyroidism being 2.8%. Due to the immense impact that the maternal thyroid disorder has on maternal and fetal outcome, prompt identification of thyroid disorders and timely initiation of treatment is essential. Thus, universal screening of pregnant women for thyroid disorder should be considered especially in a country like India where there is a high prevalence of undiagnosed thyroid disorder.
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