Predictive value of thyroid stimulating hormone as a biomarker in intrauterine growth restriction

Abstract

Normal maternal thyroid function is essential for fetal growth and neurocognitive development. Intra uterine growth restriction (IUGR) is a complex condition arising from maternal, placental, or fetal mechanisms and any imbalance in thyroid function may lead to undesirable results for both mother and fetus.The aim of this study was to co-relate the level of thyroid stimulating hormone (TSH) in clinically diagnosed cases of intra uterine growth restriction.A prospective study was conducted in a tertiary care hospital for a period of one year in which one hundred and twenty consecutive clinically suspected cases of singleton IUGR pregnancies at 34-40 weeks of gestation were enrolled. The reference level of TSH during the third trimester was taken as 0.3 to 3.0 mIU/ L. The TSH levels were recorded and a descriptive analysis of the data was performed.Among the 120 clinically diagnosed cases of IUGR only three antenatal mothers from rural background had TSH levels below 0.3 mIU/L. All three were vegetarians. In these, hypothyroid antenatal mothers, the delivery outcomes were; one was born dead while the other two babies were born alive and required caesarean section. However, the two born alive had a very low birth weight; less than 1.5 kgs and both needed admission to neonatal intensive care unit.Since the causation of IUGR is multifactorial, the role of TSH alone may not be accurate to be used as biomarker for prediction of IUGR.