FOETO-MATERNAL OUTCOME OF HYPOTHYROIDISM IN ANTENATAL MOTHERS

Abstract

Introduction: Over the past several years, it has been proved that maternal thyroid disorders influence the outcome of mother and foetus, during and also after pregnancy. The most common thyroid disorder in pregnancy is maternal hypothyroidism. Endemic iodine deficiency is the most common cause of hypothyroidism in pregnant women worldwide.

Objectives: 1. To detect cases of overt or subclinical hypothyroidism in antenatal mothers in early weeks of gestation. 2. To start early treatment in positive cases to reduce the harmful effects on maternal and foetal outcome. 3. To study the maternal complications during antenatal, intranatal and postnatal period in hypothyroid mothers. 4. To note any early neonatal complications in hypothyroid women.

Materials and methods: A randomized prospective clinical study was conducted at Department of Obstetrics and Gynaecology, Vadilal Sarabhai Hospital, Ahmedabad. Study population included all pregnant mothers attending antenatal clinic within 12 weeks of gestation. The present study was conducted for a period of one year (February 2018- January 2019) and the sample size was 300.

Results: Hypothyroid cases (TSH >3.4 μIU/ml) constituted 6.3% of the screening population. Euthyroid subjects (control TSH 0.6 – 3.4 μIU/ml) were 93.7% of the study population. Most of the mothers both in cases (72.2%) and controls (75.8%) delivered between 37-40 weeks. Spontaneous vaginal deliveries were more common in controls (75.3%) than cases (47.1%). Hypothyroid mothers had caesarean section significantly more (52.9%) than the euthyroid group (24.7%). Incidence of low birth weight babies (birth weight<2.5kg) were significantly higher in the hypothyroid mothers than the euthyroid group (23.5% vs. 9.6%).

Conclusion: The diagnosis and treatment of thyroid dysfunction in pregnancy can help prevent the harmful effects associated with it. Hence the screening of thyroid disorder in early pregnancy is important.

Keywords: Hypothyroid; Pregnancy; Iodine deficiency; Preterm labour.