Do Pregnant Women With Hypothyroidism Have a Decreased Incidence of Hyperemesis Gravidarum? [269

Abstract

INTRODUCTION: Nausea and vomiting in the early part of pregnancy affects up to 75% of pregnant women. Hyperemesis, the severe form, affects 1–2%. There is a known relationship between transient hyperthyroidism with hyperemesis, owing to the identical alpha-subunit of human chorionic gonadotropin and thyroid-stimulating hormone (TSH). We sought to determine whether the opposite was true: Do women with elevated TSH and hypothyroidism have less nausea, vomiting, and hyperemesis gravidarum? METHODS: A retrospective chart review was performed at Good Samaritan Hospital from 2009 to 2012. A total of 367 women were studied. A study group of 187 patients with hypothyroidism was compared with a control group of 180 patients without hypothyroidism. χ2 and contingency coefficients were used to analyze the data. RESULTS: Women with hypothyroidism had higher body mass index (BMI, calculated as weight (kg)/[height (m)]2) levels (30.96±8.19 compared with 28.97 ± 7.29, P=.015) and a higher incidence of diabetes mellitus (12.3% compared with 5.6%, P=.024). In contrast, the intake of vitamins (91.4% compared with 98.3%, P=.003) and iron sulfate (7.5% compared with 13.9%, P=.047) was increased in the control group. The incidence of depression, hypertension, multiple gestation, and bariatric surgery was not significant between the groups. There were no differences in the rates of nausea and vomiting of pregnancy between the groups (4.3% compared with 3.3%, P=.637) or for hyperemesis gravidarum (3.2% compared with 3.3%, P=.581). CONCLUSION: Women with hypothyroidism have higher BMIs and higher risks of gestational diabetes. They do not have a decreased incidence of nausea, vomiting, or hyperemesis in pregnancy.