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

Abstract

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.