Abstract
Background: The physiology of the thyroid gland changes during pregnancy as a result of the effects of increased TBG and hCG levels and enhanced iodine metabolism. These normal hormonal changes can sometimes make thyroid function tests during pregnancy difficult to interpret. Objective: To compare the levels of thyroxine [T4], triiodothyronine [T3], thyrotropin [TSH] and Thyroxine Binding Globulin [TBG] in grand multiparas, nulliparas [control] and primiparas. Materials: A cross-sectional study was performed in 50 non-pregnant ladies as control group, 50 primiparity pregnant women, and 50 grand multiparity pregnant women. All pregnant women were between 10th -14th weeks gestation. Methods: Serum for T4, T3, TSH and TBG were measured by Enzyme-Linked Immunosorbent Assay [ELISA] . Results: When compared to control group, serum levels of T4, T3 and TBG were increased significantly in primiparity and grand multiparity groups, while serum level of TSH was decreased significantly in both groups of pregnant women. Serum level of T4 increased significantly in grand multiparity group comparing to primiparity group. Conclusion: The results suggest that grand multiparity increased the risk of pregnancy-related complication secondary to thyroiddysfunction.
Highlights
The reports defined grand multiparity as parity starts from 5 because the threshold of risks of any obstetric complication, neonatal morbidity, and perinatal death increase markedly at parity ≥5.[1]
Total thyroxine (TT4), total triiodothyronine (TT3) and Thyroxine Binding Globulin (TBG) levels showed significant increasing in primiparity group and grand multiparity group when compared to control, while thyrotropin (TSH)
TT4 level was significantly raised in grand multiparity group comparing to primiparity, while the other levels showed insignificant changes
Summary
The reports defined grand multiparity as parity starts from 5 because the threshold of risks of any obstetric complication, neonatal morbidity, and perinatal death increase markedly at parity ≥5.[1] High parity and reduced inter-pregnancy interval are reported to be risk factors for poor maternal and perinatal outcome. The physiology of the thyroid gland changes during pregnancy as a result of the effects of increased thyroxine binding globulin and human chorionic gonadotropin levels and enhanced iodine metabolism. These normal hormonal changes can sometimes make thyroid function tests during pregnancy difficult to interpret.
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