Pregnancy outcomes in subclinical hypothyroidism and thyroid autoimmunity

Abstract

Context: This is a study on “pregnancy outcomes in subclinical hypothyroidism (SCH) and thyroid autoimmunity,” as the data from previous Indian studies is inconclusive. Aims: The aims were to evaluate pregnancy outcomes in SCH and to compare outcomes with and without thyroid peroxidase antibodies (TPOAbs). We also looked at pregnancy outcomes in euthyroid in relation to TPOAb. Design: This is an observational, prospective, cohort study. Subjects and Methods: One Hundred (50 SCH and 50 euthyroid) pregnant women are recruited in the study. Samples are analyzed for thyroid stimulating hormone, free T4, and TPOAb. SCH women are treated with levothyroxine. Pregnancy outcomes that are, miscarriage, pregnancy induced hypertension (PIH), gestational diabetes, preterm (PT) delivery, cesarean section (CS), Apgar score, and birth weight are recorded in follow-up. Statistical Analysis: Unpaired t-test and standard error of the difference between proportions are used for statistical analysis. P < 0.05 is considered as significantResults: Pregnancy outcomes between cases and controls, TPOAb positive and negative cases are similar. However, there is a significant increase of PT deliveries (10% vs. 0) and CS (36.73% vs. 15%) in cases when compared to TPOAb negativecontrols. PIH (6.67% vs. 0) is significantly higher in TPOAb positive controls when compared to TPOAb negative controls. Conclusions: Adverse pregnancy outcomes are not significantly higher in treated SCH when compared to euthyroid women, and TPOAb status have not affected the outcomes in SCH. However, there are significantly higher PT deliveries and need for CS in SCH compared to TPOAb negative euthyroid women. Euthyroid women with TPOAb are associated with significantly higher risk of PIH.