Thyroid Dysfunction And Pregnancy Outcome

Abstract

Several studies conducted across the globe have reported a high prevalence of thyroid disorders in pregnant women. However evidence relating to adverse fetal and pregnancy consequences of maternal thyroid disorders are less well defined and not consistent. This study was thus conducted to find out the prevalence of thyroid disorders in pregnant ladies and to evaluate the adverse pregnancy outcomes in pregnant women with such disorders.This study was conducted in the Central Clinical Laboratory,of Gauhati Medical College & Hospital. Records of TSH reports of samples received from the obstetrics ward and the labour room were maintained and analysed. Follow up of all the cases included in the study was done with regards to fetal and pregnancy outcome with the help of labour room records.During the 1 year period of study 9117 samples were received . Of them 1671 (18.33%) were found to be hypothyroid and 137(1.5%) hyperthyroid. Pre-eclampsia was the most common adverse outcome observed in 20.83% of hypothyroid ladies as compared to 9.1% in ladies with normal TSH levels.Other adverse outcome was preterm birth in 14.8%, low birth weight 17.14% and fetal death in 3.89% of hypothyroid cases. In pregnant ladies with hyperthyroidism significantly high percentage of adverse outcome was also noted. Preeclampsia 15.33%, preterm delivery 10.21%, low birth weight 33.06%,and fetal death 2.19%.The findings of this study are in accordance with those of previous studies which have reported high incidence of adverse outcome in pregnant ladies with thyroid disorders. Considering the findings of this and other similar studies it is highly appropriate to consider routine screening of pregnant ladies with TSH test so that thyroid disorders can be diagnosed early in pregnancy and adequately treated to avoid the adverse consequences.