Prevalence of overt and subclinical thyroid dysfunction in pregnant women and outcome in a tertiary care centre

Abstract

Aim: To know the prevalence of overt and subclinical thyroid disorders in Indian pregnant women and to know the effect of overt and subclinical thyroid dysfunction on maternal and fetal outcome.
 Materials and methods: This study was conducted at the Government Maternity Hospital, sultan bazaar, Osmania medical college, Hyderabad over a period of 15 months from august 2016 to October 2017. 1000 pregnant women who attended the antenatal clinic were screened for the thyroid dysfunction. Serum TSH level estimated. fT3, fT4 and anti TPO Ab levels were estimated if the TSH level was abnormal. Patients were managed accordingly and followed till the delivery. Maternal and fetal outcome recorded.
 Results: It was a prospective study done on 1000 antenatal women. Prevalence of thyroid disorder in this study was 11.3%. Prevalence of subclinical, overt hypothyroidism, subclinical and overt hyperthyroidism was 9.4%, 1.4%, 0.4% and 0.1% respectively. Subclinical hypothyroidism was associated with complications like preeclampsia (13.8%), Anaemia (15.95%), preterm delivery (6.38%), Intrauterine growth restriction (4.25%), low birth weight (12.76%) and Intrauterine fetal death)(2.12%). Overt hypothyroidism was associated with complications like Preeclampsia (14.28%), anaemia (21.4%), Preterm delivery (14.28%), intrauterine growth restriction (14.28%), low birth weight (21.4%) and Intrauterine fetal death (7.14%). Incidence of CD was 18.05% in women with hypothyroidism. Subclinical hyperthyroidism was associated with complications like Preeclampsia, Preterm delivery, Intrauterine growth restriction, Intrauterine fetal death.
 Conclusion: Thyroid disorders in pregnancy are significantly associated with both maternal and fetal complications and adversely affect the outcome of pregnancy. Hence, early identification of thyroid disorders and timely initiation of treatment is essential