Association between Serum Albumin and Hypothyroidism in Preeclampsia: A Case-control Study

Abstract

Introduction: Preeclampsia is a cause of high morbidity and mortality in pregnant women. Serum albumin is found to be low in preeclampsia. Few recent studies have shown a state of hypothyroidism in preeclampsia. Aim: To find the association between the serum albumin and thyroid hormone levels in preeclampsia and seek to find if hypoalbuminemia increases the risk of hypothyroidism. Materials and Methods: A case-control study was done at Department of Biochemistry and the Department of Obstetrics and Gynaecology of Government Medical College, Thiruvananthapuram, Kerala, with 40 preeclampsia cases and 40 normal pregnant controls, in 30-38 week gestation. Serum albumin and thyroid profile-Total T3, Total T4, Thyroid Stimulating Hormone (TSH), freeT3 (fT3), freeT4 (fT4) were tested. Statistical analysis was done with Student’s t-test, Chi-square, Fischer’s t-test and Pearson’s correlation coefficients. Results: The mean serum albumin was significantly lesser in preeclampsia (3.11±0.39) than in controls (3.7±0.14 g/dL). Thyroid hormones were significantly decreased in preeclampsia. TSH was significantly raised (3.76±1.55 mIU/L) in preeclampsia compared to normal pregnant ladies (2.3±0.94 mIU/L). In cases with hypoalbuminemia, risk for hypothyroidism was 2.85 times compared to those with normal albumin but was not statistically significant. In severe preeclampsia, there was a two times increased risk. There was a negative correlation of TSH and positive correlation for fT4 with serum albumin. However, this was statistically not significant. Conclusion: Hypothyroidism in preeclampsia was not significantly correlated with hypoalbuminemia in this study. Thus hypoalbuminemia did not significantly increase the risk for hypothyroidism in our study. Further studies are needed to determine the risk factors affecting thyroid function in preeclampsia.