ASSOCIATION OF SUBCLINICAL HYPOTHYROIDISM WITH INCREASED RISK OF RECURRENT MISCARRIAGES DURING ANTENATAL THYROID STIMULATING HORMONE SCREENING

Abstract

Objective: The present study was designed to ascertain the association of raised TSH in sub-clinical hypothyroidism with history of miscarriages in pregnant females coming to Al-Nafees Medical College Islamabad, for antenatal care. Material and Methods: This Comparative cross-sectional study was conducted at department of Biochemistry, in assistance with Gynecology/ Obstetrics and Pathology department of Al-Nafees Medical College & Hospital Islamabad, Pakistan. In this study random screening of 150 pregnant females for serum TSH levels was done to identify cases of SCH. Females were divided in to three equal groups i.e., 50 females in first, second and third trimester each. We measured serum TSH levels by using ELISA and then observe association of the raised TSH levels with Hx miscarriages. Data were analyzed by SPSS version 20. Statistical methods used to analyze the data included mean ± SD, percentages, ratio, ANOVA and Pearson correlation tests Results: The data obtained from this study indicates that 34.7% of females were found positive for SCH in our local population. Trimester wise reference values of TSH as given by ATA guidelines were used for diagnosing cases of SCH. In our study we found a statistically significant association of raised TSH levels with Hx miscarriages as depicted by a significant p-Value ≤ 0.001. Conclusion: Therefore, it is concluded from our study that there is an increased incidence of miscarriages in SCH positive females in contrast to females with normal TSH levels. Therefore, this finding highlights the role of antenatal TSH screening to avoid maternal and fetal poor outcome i.e., miscarriages associated with raised TSH levels. Key Words: Subclinical hypothyroidism, Serum TSH levels, Obstetrical outcomes, Miscarriages, Trimester specific cut off values for TSH.