Hypothyroidism In Pregnant Women Research Articles

Evaluation of the clinical course of hypertensive disorders against the background of subclinical hypothyroidism in pregnant women

Background. Hypertensive disorders during pregnancy, such as gestational hypertension and preeclampsia, pose significant health risks. They require a personalized treatment approach due to their multifactorial nature. The presence of subclinical hypothyroidism may exacerbate these risks, making thyroid function monitoring before and during pregnancy particularly important.The aim. To investigate the clinical features and severity of hypertension in newly diagnosed subclinical hypothyroidism among women in Andijan.Methods. A case-control study conducted from November 2022 to April 2023 included 272 pregnant women aged 18 to 40 years without chronic diseases. The main group comprised 88 women diagnosed with hypertension after the 20th week of pregnancy. The control group consisted of 184 women without hypertension. The study excluded HIV-positive women, as well as those with congenital anomalies or who had undergone surgical interventions on the genitourinary and cardiovascular systems. Socio-demographic and lifestyle characteristics of the participants were studied. The analysis revealed significant differences in age, activity level, place of residence, employment, and education, as well as a correlation between body mass index, health status, and hypertension severity.Results. The findings underscored the importance of thyroid function monitoring during pregnancy, linking hypertension to age, activity level, and obesity. This confirms the necessity for a comprehensive approach to pregnancy management, including thyroid function and lifestyle modifications.

The association of back pain with physical inactivity and hypothyroidism in pregnant women.

During pregnancy, structural and functional changes usually occur in the body, which has various consequences, including lower back pain (LBP) and hypothyroidism. One of the risk factors for these problems is physical inactivity. This study aimed to investigate the association of back pain and physical inactivity, weight gain, and hypothyroidism in pregnant women. In this cohort study, 420 pregnant women (26.333 ± 5.820 years old) were included. At first, participants answered this question: "Do you have any plans for pregnancy in the next month?" If the answer was yes, further evaluations were performed. The physical activity and pain intensity were measured by the International Physical Activity Questionnaire Short Form (IPAQ-S) and Visual Analogue Scale. Serum TSH was measured by automated chemiluminescence and commercial kits. Measurements were conducted before, the first, second, and third trimester of pregnancy. Women reporting LBP were less engaged in physical activities and weight gained in the second and third trimesters of pregnancy was significantly higher than pregnant women without LBP (p< 0.05). TSH level and weight gained in pregnant women with low physical activity level was significantly higher than pregnant women with moderate and high physical activity (p< 0.05) (without significant difference in TSH and BMI). The physical inactivity (before: OR: 1.11 95% CI: 0.89 to 1.22; first trimester: OR: 1.09 95% CI: 1.02 to 1.59; second trimester: OR: 0.92 95% CI: 0.87 to 1.31; third trimester: OR: 1.12 95% CI: 1.02 to 1.39), TSH (OR: 0.85 95% CI: 0.57 to 1.29), and weight gain (second trimester: OR: 0.87 95% CI: 0.92 to 1.59; third trimester: OR: 1.44 95% CI: 1.02 to 1.98; p< 0.05) did predict increased pain intensity. Using health-oriented approaches to increase physical activity and normalize thyroid function and weight gain during pregnancy can have beneficial effects on LBP.

Prevalence of thyroid dysfunction among pregnant women in the horn of Africa: A systematic review and Meta-analysis

BackgroundThyroid dysfunction ranks among the most prevalent endocrine disorders. This disorder during pregnancy has been linked to adverse effects on both the mother and the baby. However, there is a scarcity of data and inconsistent documentation regarding thyroid issues in pregnant women in low-income nations. ObjectiveThe aim of this systematic review and meta-analysis was to determine the general prevalence of thyroid disorders in pregnant women. MethodsTo identify relevant studies, a comprehensive search was conducted across Scopus, PubMed, Science Direct databases, and Google Scholar and repository registers from January 1, 2000 to December 31, 2023. Ten pertinent publications were chosen for the final meta-analysis. Relevant data was extracted using Microsoft Excel and analyzed using STATA software version 17, employing a random-effect model. Sensitivity analysis was conducted to evaluate each study's impact on the outcome, and Egger's test was utilized to detect publication bias. A trim-and-fill analysis was executed to adjust for bias in the effect estimate. Heterogeneity across studies was assessed using Cochran's Q statistic and I2 statistics. Subgroup analysis was carried by study design, country and publication year. ResultsIn this systematic review and meta-analysis, the prevalence of thyroid dysfunction among 2538 pregnant women was 12.0 % (95 % CI: 8.00 %–17.00 %). To account for the significant heterogeneity observed, a random effect model was utilized. Specifically, the prevalence of hypothyroidism in pregnant women was determined to be 10.00 % (95 % CI: 4.00–16.00 %) with a high level of heterogeneity (I2 = 94.27 %, p < 0.001). Notably, the sensitivity analysis conducted did not reveal any substantial impact on the overall pooled prevalence of thyroid dysfunction. ConclusionThe meta-analysis revealed a significantly higher rate of thyroid disorders among pregnant women compared to global estimates. To assess the effects of treating thyroid conditions on pregnancy outcomes and inform clinical decisions, it is recommended to implement cost-effective thyroid-stimulating hormone screening during pregnancy.

Maternal hypothyroidism and the risk of preeclampsia: a Danish national and regional study

BackgroundMaternal hypothyroidism in pregnancy has been proposed to increase the risk of preeclampsia, but uncertainties persist regarding the underlying causal mechanisms. Thus, it remains unclear if an increased risk of preeclampsia in hypothyroid pregnant women is caused by the lack of thyroid hormones or by the autoimmunity per se.MethodsWe conducted a retrospective study of two pregnancy cohorts in the Danish population. The nationwide cohort (n = 1,014,775) was register-based and included all singleton pregnancies in Denmark from 1999–2015. The regional cohort (n = 14,573) included the biochemical measurement of thyroid stimulating hormone (TSH), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab) (ADVIA Centaur XPT, Siemens Healthineers) among pregnant women in The North Denmark Region from 2011–2015 who had a blood sample drawn in early pregnancy as part of routine prenatal screening for chromosomal anomalies. The associations between diagnosed and biochemically assessed hypothyroidism and a diagnosis of preeclampsia were evaluated using logistic regression (adjusted odds ratio (aOR) with 95% confidence interval (CI)) adjusting for potential confounders, such as maternal age, diabetes, and parity.ResultsIn the nationwide cohort, 2.2% of pregnant women with no history of hypothyroidism (reference group (ref.)) were diagnosed with preeclampsia, whereas the prevalence was 3.0% among pregnant women with hypothyroidism (aOR 1.3 (95% CI: 1.2–1.4)) and 4.2% among women with newly diagnosed hypothyroidism in the pregnancy (aOR 1.6 (95% CI: 1.3–2.0)). In the regional cohort, 2.3% of women with early pregnancy TSH < 2.5 mIU/L (ref.) were diagnosed with preeclampsia. Among women with TSH ≥ 6 mIU/L, the prevalence was 6.2% (aOR 2.4 (95% CI: 1.1–5.3)). Considering thyroid autoimmunity, preeclampsia was diagnosed in 2.2% of women positive for TPO-Ab (> 60 U/mL) or Tg-Ab (> 33 U/mL) in early pregnancy (aOR 0.86 (95% CI: 0.6–1.2)).ConclusionsIn two large cohorts of Danish pregnant women, maternal hypothyroidism was consistently associated with a higher risk of preeclampsia. Biochemical assessment of maternal thyroid function revealed that the severity of hypothyroidism was important. Furthermore, results did not support an association between thyroid autoimmunity per se and preeclampsia.

Prevalence and feto-maternal outcomes of subclinical hypothyroidism in pregnancy among mothers attending a tertiary care hospital of Darjeeling District, West Bengal, India

Background: Pregnancy is a stressful test for the mother’s thyroid function. The frequency of hypothyroidism in pregnant women is high. However, there are no adequate studies to evaluate the adverse effects of subclinical hypothyroidism (SCH) during pregnancy. Aims and Objectives: This study was carried out to evaluate the prevalence of SCH in pregnancy and its adverse feto-maternal outcomes among mothers attending a tertiary care teaching hospital in Darjeeling district, West Bengal, India. Materials and Methods: The present study was an institution-based observational descriptive study with a prospective longitudinal design conducted for 1 year among pregnant women attending the antenatal clinic of the study institution in the first trimester of their pregnancy. The sample size for the present study was calculated to be 200. A consecutive sampling technique was utilized. The enrolled women were evaluated for thyroid status by assessing serum thyroid stimulating hormone and free T4 level. All the enrolled mothers were kept under close follow-up and they were evaluated for the development of any antenatal, intranatal, and postnatal complications. Results: The mean age was found to be 23.1±4.2 years, most of the women were nulliparous (60%). Of the women, 74% were euthyroid, while the prevalence of SCH was found to be 16%. On follow-up till the termination of their pregnancies, mothers suffering from SCH had statistically significantly higher incidence of maternal complications such as hypertensive disorders in pregnancy (P=0.001), abortion (P&lt;0.001), postpartum hemorrhage (P=0.020) and also fetal adverse outcomes, such as intrauterine growth restriction (P=0.018), fetal premature birth (P=0.035), and low birth weight (P=0.004) when compared with euthyroid mothers. Conclusion: The burden of SCH high in the study population, and it was significantly associated with a number of different maternal as well as fetal complications and adverse outcomes.

Study of the functional state of the thyroid gland in pregnant women with hypothyroidism

Currently, hypothyroidism is emerging as a significant issue worldwide. According to statistics, the global incidence of hypothyroidism is second only to diabetes. Various types of iodine deficiency diseases are recognized, including hypothyroidism, endemic goiter, hyperthyroidism, thyroid cancer, etc. The prevalence of hypothyroidism ranks first in Kazakhstan. Changes in the level of thyroid hormones during the reproductive period can also significantly impact the expectant mother and the developing fetus. Many chemicals that pollute the environment inhibit protective immunophysiological mechanisms, reduce the body’s ability to adapt, increase the frequency of reproductive system diseases, and alter their course. A decrease in the quality of the environment, social discomfort, and large man-made disasters lead to environmentally dependent transitions and pathological changes in various organs and systems of a person, resulting in a decrease in life expectancy. In this regard, improving the health of the population is an important issue in medicine. In this article, a comparative analysis of the development of hypothyroidism in pregnant women in Almaty and Aktobe was carried out.

The Effect of Inflammatory Markers in the Hemogram Parameters of Pregnant Women with Thyroid Disease on Obstetric and Neonatal Outcomes

Aim: This study aimed to determine the differences in hemogram parameters, especially in inflammatory markers and perinatal and neonatal outcomes of pregnant women with thyroid disease, and to examine the effects of these differences on pregnancy outcomes. Material and Methods: The data of 80 pregnant women diagnosed with thyroid disease according to the American Thyroid Association (ATA) criteria at the first admission between 2016 and 2019 and 100 pregnant women whose thyroid hormone levels were within the normal reference range were retrospectively analyzed. Obstetric outcomes such as type and time of delivery, and the presence of additional disease during pregnancy, and neonatal outcomes such as weight, gender, and Apgar score at birth were compared. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), white blood cell (WBC) count, and hemoglobin (Hb) and mean platelet volume (MPV) values, which are accepted as inflammation markers, were also compared between groups. Results: There was no significant difference between hypothyroid and hyperthyroid pregnant women in terms of Hb (p=0.319) and PLR (p=0.341) values. Third-trimester WBC (p=0.015) values were higher and MPV (p=0.007) values were lower in the hypothyroid pregnant women compared to the control group. The highest NLR (p=0.005) value was observed in the hypothyroid group. Comorbidities were found to be 27.4% (n=20) in the hypothyroid group, 14.3% (n=1) in the hyperthyroid group, and 1.0% (n=1) in the control group (p&amp;lt;0.001). Conclusion: Pregnant women with thyroid disease may have differences in hemogram parameters, especially in inflammatory markers, and these differences may affect pregnancy outcomes.

Symposium 15: Impact of Environmental Contaminants on Child Neurodevelopment

Summary Abstract:Children are exposed to toxic chemicals throughout development and the long-term consequences of this exposure can be profound. Despite decades of research documenting the vulnerability of the developing brain to environmental contaminants, there has been little progress in protecting against developmental neurotoxicity. This symposium will discuss recent research in developmental neurotoxicology using a "developmental origins of health and disease" (DOHaD) framework that examines the context in which environmental contaminants exert their effects. We will examine the timescale for developmental toxicity, windows of vulnerability, and the bases of individual differences in vulnerability, including sex-specific effects of chemical exposures. This symposium will feature new pregnancy and birth cohort studies that have implicated fluoride as a developmental neurotoxin and endocrine disruptor. In addition, we will discuss emerging issues in epidemiology, including how environmental contaminants may interact with non-chemical stressors and have lifelong impacts on cognition and behaviours. This symposium will be capped with a discussion of the public's knowledge, attitudes, and behaviours related to developmental toxicity and strategies to reduce exposure. All speakers will be asked to draw conclusions on research priorities, and discuss how to balance regulators' need for "ideal evidence" with a public health strategy that aims to protect the public from critical environmental hazards. The symposium will consist of the following five presentations, each 12 minutes in length, followed by a 15 minute discussion.1. John Krzeckowski, PhD, York University, Toronto, Canada.TITLE: Applying a Dimensional Framework to the Study of Developmental Neurotoxicity2. Carly Goodman, PhD candidate, York University, Toronto, CanadaTITLE: Sex difference of Developmental Neurotoxicants on Intellectual abilities: A systematic review and meta-analysis3. Meaghan Hall, PhD candidate, York University, Toronto, Canada.TITLE: Fluoride Exposure and Hypothyroidism in Pregnant Women: A Potential Mechanism of Fluoride Neurotoxicity4. Ashley Malin, PhD, University of Florida,Florida, USA.TITLE: Urinary Fluoride Levels and Metal Co-Exposures among Pregnant Women in Los Angeles, California5. Rivka Green, PhD, The Hospital for Sick Children, Toronto, Canada.TITLE: Translating developmental neurotoxicity for the public: A large, multi-country, randomized-control trial investigating children's environmental health literacy

3 Fluoride Exposure and Hypothyroidism in Pregnant Women: A Potential Mechanism of Fluoride Neurotoxicity

Objective:Fluoride exposure has been associated with thyroid dysfunction, but fluoride's impact on thyroid function in pregnancy is unclear, especially during early gestation when the fetus is dependent on maternal thyroid hormone. We examined the potential thyroid-disrupting effects of maternal fluoride exposure in pregnancy and tested whether thyroid disruption in pregnancy mediates the association between maternal fluoride exposure and child intelligence quotient (IQ) among Canadian mother-child dyads living in areas with optimal fluoridation.Participants and Methods:We measured fluoride concentrations in drinking water and in spot urine samples collected in each trimester from pregnant women enrolled in the Maternal-Infant Research on Environmental Chemicals study. We also measured thyroid hormone (thyroid stimulating hormone [TSH], free thyroxine [FT4], and total thyroxine [TT4]) levels during the first trimester of pregnancy and categorized women as euthyroid (n=1301), subclinical hypothyroid (n=100), or primary hypothyroid (n=28). Those categorized as primary hypothyroid were combined with an additional 79 women who reported clinical diagnoses at time of study enrolment (total n=107). In a sample of 1508 women, we used logistic regression to estimate the association between fluoride exposure and risk of either subclinical or primary hypothyroidism, separately, and linear regression to estimate associations between fluoride exposure and women's thyroid hormone levels (TSH, FT4, TT4). We tested effect modification by child sex and thyroid peroxidase (TPO) antibody status. In a subsample of 439 mother-child pairs, we measured child Full-Scale IQ (FSIQ) at 3-4 years of age using the Wechsler Preschool and Primary Scale of Intelligence. We used linear regression to test associations between maternal hypothyroidism or thyroid hormone levels, and children's FSIQ scores. Finally, mediation analysis in the counterfactual framework was used to estimate the proportion of the effect of maternal fluoride exposure on child FSIQ mediated by maternal hypothyroidism, through evaluation of the natural direct (not through hypothyroidism) and indirect (through hypothyroidism) effects.Results:Using categorical measures of thyroid status, a 0.5 mg/L increase in water fluoride concentration was associated with a 1.64 (95% confidence interval [CI], 1.04 to 2.58) increased odds of primary hypothyroidism. This association was stronger among women with normal TPO antibody levels (&lt; 5.61 IU/mL) (odds ratio, 2.80; 95% CI, 1.24 to 6.36). In contrast, we did not find a significant association between maternal urinary fluoride and hypothyroidism. For continuous measures of thyroid hormone levels, a 1 mg/L increase in maternal urinary fluoride was associated with a 35% (p=0.01) increase in TSH among women pregnant with a female fetus. In our subsample analyses, children born to women with primary hypothyroidism had lower FSIQ than children of euthyroid women, especially among boys (B, 8.78; 95% CI, -16.78 to -0.79). In contrast, maternal TSH, FT4, and TT4 levels were not significantly associated with child FSIQ scores. Maternal primary hypothyroidism did not significantly mediate the relationship between maternal water fluoride concentration and child FSIQ (p natural indirect effect= .35).Conclusions:Fluoride in drinking water may increase the risk of hypothyroidism in pregnancy. Thyroid dysfunction in pregnancy may be one mechanism underlying developmental neurotoxicity of fluoride.

Prevalence of Hypothyroidism in Pregnancy in a Tertiary Care Hospital

Introduction: Thyroid disorders are the most common endocrine disorders affecting women of reproductive age. The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. During early pregnancy, the fetus is totally dependent on maternal thyroid hormone supply. Thyroid hormone is critical for fetal brain and intellectual development. Thyroid hormone is also important for some preventable pregnancy complications like anaemia, low birth weight, abruptio placenta, preeclampsia, etc., which pose special risks for the mother and developing fetus. Aim of the study: To assess the prevalence of hypothyroidism in pregnant women and thus ensure appropriate treatment for the wellbeing of the mother and baby. Methods: This prospective obsessional study was conducted on 113 pregnant women at US Bangla Medical College Hospital, Dhaka, Bangladesh, who attended obstetrics outdoors. Women were randomly chosen irrespective of age, parity, residence, and socioeconomic status. Women with multiple pregnancies or having any pre-existing medical disorder were excluded. All women were investigated for TSH along with routine pregnancy tests. All were divided into two groups: normal/euthyroid and abnormal/thyroid disorders, considering their thyroid status. Result: We found the prevalence of thyroid dysfunction in pregnancy was 17.7%, with hypothyroidism being 15.93%, of which 10.62% were subclinical hypothyroidism, 5.31% were cases of overt hypothyroidism, and 1.77% were cases of hyperthyroidism. Conclusion: This study showed an increased prevalence of hypothyroidism in pregnancy, recommending a need for universal screening for all pregnant women in the early weeks of pregnancy. This study aims at validating the efficacy of the above-mentioned screening for a better pregnancy outcome.

The Effects of Maternal Smoking on Thyroid Function: Findings from Routine First-Trimester Sonographic Anomaly Screening.

This study aimed to assess the effect of tobacco exposure on maternal thyroid function and investigate its relationship to subclinical hypothyroidism in pregnant women during the first trimester. A comparison of maternal thyroid function was made on 45 smokers, who composed the study group, and 72 non-smokers, pregnant women, who constituted the control group. After determining smokers by questionnaire, carbon monoxide (CO) levels in the expiratory air of the participants in both groups were measured and recorded, and the smokers' exposure was objectively confirmed. Smoking and non-smoking pregnant women were similar regarding body mass index (BMI). While the TSH and fT4 levels were respectively 1.48 mlU/L and 11.43 pmol/L in pregnant women who smoked, that ratio changed to 1.72 mlU/L and 11.17 pmol/L in the non-smokers' group. But the differences between the groups were not statistically significant (p=0.239, p=0.179). Even though the rate of subclinical hypothyroidism was 8.9% in the smoking group, it was approximately 19.4% in the non-smoker group; the difference was not statistically significant (p=0.187). This study proved that there is no statistically significant difference between maternal serum TSH and fT4 levels and the rate of subclinical hypothyroidism in smokers during pregnancy in the first trimester.

Expressions of mitochondria-related genes in pregnant women with subclinical hypothyroidism, and expressions of miRNAs in maternal and cord blood

BackgroundSubclinical hypothyroidism in pregnancy and definition by upper thyrotropin (TSH) cutoff are controversial. As mitochondria are influenced by thyroid hormones, the purpose in this study was to measure expression of mitochondria-related genes in euthyroid and subclinical hypothyroid pregnant women to obtain more knowledge of potential metabolic consequences of maternal subclinical hypothyroidism. In addition, we wished to test if applied TSH-cutoff significantly changed our results of expressed gene-levels. Moreover, we aimed to identify potential microRNA-biomarkers for subclinical hypothyroidism – markers that could be traced to offspring as well.MethodsFrom a cohort of at-term pregnant women undergoing planned cesarean section, 77 women had expression levels of the mitochondria-related genes Peroxisome Proliferator-activated Receptor-γ coactivator-1β (PGC-1β), mitochondrial Transcription Factor A (TFAM), Superoxide Dismutase 2 (SOD2) and Nuclear Respiratory Factor 2 (NRF-2) determined by qPCR from blood sampled in prior to delivery. Two TSH-cutoff levels defining subclinical hypothyroidism (> 3.0 and > 3.7 mIU/L) were applied for the procession of results, generating two data analyses of the same cohort. In 22 pairwise maternal-cord samples (subclinical hypothyroid/euthyroid-rate 0.5, TSH-cutoff > 3.0 mIU/L), microRNA-expressions (miRNA) were analyzed.ResultsAll gene expressions were lower in the subclinical hypothyroid group regardless of applied TSH-cutoff, but insignificant except for PGC-1β at TSH cutoff > 3.0 mIU/L. Two miRNAs (hsa-let-7d-3p and hsa-miR-345-5p) were upregulated in blood from women and offspring (cord blood) with subclinical hypothyroidism.ConclusionsA trend towards decreased mitochondrial gene expressions in subclinical hypothyroidism were demonstrated. The miRNAs hsa-let-7d-3p and hsa-miR-345-5p might be potential markers of maternal subclinical hypothyroidism. However, larger studies are needed to verify the findings.

PREGNANCY AND THYROID FUNCTION

The article presents the results of determining the frequency of thyroid dysfunction among pregnant women in the third trimester, the relationship of factors with it, and analysis of the effect of thyroid dysfunction on pregnancy outcomes. The study involved 77 women with singleton pregnancies in the third trimester; the average age was 28.7±2.11 years. In all patients, thyroidstimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) were determined in the blood. Statistical analysis was performed using Microsoft Excel Statistica. In 39.0% of cases, thyroid dysfunction was revealed: subclinical hypothyroidism was detected in 26% of women, overt hypothyroidism in 7.8%, subclinical hyperthyroidism - in 5.2%. In subclinical hypothyroidism, the TSH level was 74.6% (p=0.001), in pregnant women with overt hypothyroidism - by 81.3% (p=0.001) higher than in pregnant women with euthyroidism. In pregnant women with subclinical hypothyroidism, overt hypothyroidism and subclinical hyperthyroidism, the T3 level was reduced by 38.2% (p=0.355), by 78.6% (p=0.004) and by 11.1% (p=0.741), respectively. The T4 value in the blood in women with subclinical hypothyroidism and subclinical hyperthyroidism in comparison with the group with normal functioning of the thyroid gland was increased by 34.6% (p=0.261) and by 39.0% (p=0.004), and in pregnant women with obvious hypothyroidism decreased by 75.6% (p=0.003). In the group of women with subclinical hypothyroidism, 35.0% suffered from anemia, 20.0% of women had preeclampsia, oligohydramnios - in 30.0%, caesarean section - in 35.0% of women. The risk of preeclampsia, anemia, oligohydramnios, caesarean section and premature birth in women with subclinical hypothyroidism, respectively, 5.6 times (p&lt;0.01), 7.9 times (p&lt;0.01), 4.6 times (p&lt;0.05), 3.7 times (p&lt;0.05) and 1.7 times (p&gt;0.05) higher than in those examined with euthyroidism. A statistically significant relationship was established between anemia, preeclampsia, caesarean section, the presence of children with low body weight, and a low Apgar score with subclinical hypothyroidism. Evaluating the strength of the association between hypothyroidism and pregnancy outcome variables may help unify screening and subsequent management of hypothyroid pregnant women.

Frequency of Pregnancy Induced Hypertension (PIH) in Patients Presenting with Hypothyroidism

Objective: Preeclampsia is a potentially fatal condition during pregnancy and following delivery. Numerous organs' functions can be influenced by preeclampsia. It is crucial, as this illness may be linked to abnormalities in thyroid function. Therefore, the aim of this study was to assess the frequency of thyroid dysfunction and its association with hypertension in pregnant women. Methodology: This descriptive cross sectional study was conducted at Obstetrics and Gynecology Unit-I, Civil Hospital, Karachi, using a non-probability consecutive sampling technique. The duration of the study was about six months from October 2022 till March 2023. A total of 80 pregnant women who were between the ages of 18 and 40, had gestational ages between 20 and 40 weeks, and had laboratory results that suggested hypothyroidism were included in this study. A chi-square test was applied to evaluate the association between maternal age, parity, gestational age, serum levels of TSH and T4 and pregnancy induced hypertension. Results: The study findings showed that most of the women 33(41.25%) were between 26 to 35 years of age. The mean age of the pregnant women was 29.43±4.64 years. The mean parity was 1.74±0.83 and the mean gestational age was 30.33±5.22 weeks, and the mean duration of hypothyroidism was 4.27±2.06 years. Concerning thyroid parameters, the mean T4 was 5.79±1.21 pmol/L, and the mean TSH was 6.28±2.03 mIU/L. Additionally, there was an insignificant association observed between pregnancy induced hypertension and maternal age, gestational age, parity, and thyroid hormone parameters. Conclusion: This study concluded that alterations in the thyroid function of pregnant women led to pregnancy induced hypertension. Only 25% of hypothyroid pregnant women had gestational hypertension. Furthermore, age, parity, gestational age, and thyroid parameters of pregnant women were insignificantly associated with pregnancy induced hypertension. Keywords: Pregnancy induced hypertension, hypothyroidism, gestational age.

Study of Perinatal Outcome and Neonatal Hypothyroidism in Pregnant Women with Hypothyroidism Delivering in a Tertiary Care Centre in Western Nepal

Introduction: Hypothyroidism is a common endocrine problem in pregnant women with a reported prevalence of 1.5 to 4.4%. Both overt and subclinical hypothyroidism have adverse effects on perinatal outcome.&#x0D; Aim and Objective: To find the prevalence of hypothyroidism in pregnancy and its impact on perinatal outcome and neonatal hypothyroidism in a tertiary centre in western Nepal.&#x0D; Methods: This is a retrospective descriptive study conducted from April 2018 to April 2022 involving 75 hypothyroid pregnant women during their antenatal check-ups. It also included known cases of hypothyroidism. The hospital records of all the hypothyroid women who delivered in this centre were reviewed. The prevalence of subclinical and overt hypothyroidism were calculated. The relationship between the status of hypothyroidism and perinatal outcome in terms of mode of delivery, APGAR scores, birth weight and admission to neonatal intensive care unit were evaluated.&#x0D; Results: The prevalence of maternal hypothyroidism was 0.92% with subclinical hypothyroidism being 0.29% and overt hypothyroidism being 0.63%. The perinatal outcomes in terms of mode of delivery, APGAR scores, birth weight and admission to neonatal intensive care unit were not statistically significant between subclinical and overt hypothyroidism.&#x0D; Conclusion: The prevalence of maternal hypothyroidism, especially subclinical hypothyroidism was low. There were no significant adverse effects on perinatal outcome.

Correlation of Maternal Thyroid Stimulating Hormone Levels With Lipid Profile in Pregnant Women With Hypothyroidism.

Introduction Pregnancy leads to changes in hormonal levels and lipid profile. Thyroid hormones play a crucial role in embryonic growth and fetal development. Untreated thyroid disease during pregnancy can lead to a high risk of complications. Aim The aim of the study is to examine the correlation between thyroid stimulating hormone (TSH) and lipid profile in pregnant women with hypothyroidism. Materials and methods This cross-sectional case-control study was conducted at the Biochemistry Department, Alfalah School of Medical Science & Research Centre, Dhauj, Faridabad, Haryana, India.The study consisted of 500 patients (250 cases and 250 controls) who fulfilled the inclusion and exclusion criteria. Of the 250 cases recruited, 23 cases were in the 2nd trimester and 209 cases were in the 3rd trimester. Blood samples were collected from the participants to assess their lipid profile and TSH levels. Results The study showeda statistically significant difference between the mean TSH levels of hypothyroid pregnant females in the 2nd trimester (3.85 ± 0.59) and the 3rd trimester (4.71 ± 0.54). There was a significant positive correlation observed between TSH and Total Cholesterol, Triglycerides, and LDL-C in both the 2nd and 3rd trimesters.In the second trimester, there was a significant positive correlation observed between TSH & TC (r = 0.6634, p<0.0005), TSH & TG (r= 0.7346, p=0.00006), TSH & LDL (r= 0.5322, p= 0.008). In the third trimester, there was a significant positive correlation observed between TSH & TC (r = 0.8929, p<0.00001), TSH & TG (r= 0.430, p<0.00001), TSH & LDL (r= 0.168, p= 0.015). However, no significant correlation was found between TSH levels and HDL-C in either trimester. The correlation coefficient and p-value for TSH & HDL were r = 0.2083, p=0.340 in the second trimester, and r = 0.0189, p=0.2384 in the third trimester. Conclusion A significant increase in TSH levels in hypothyroid pregnant women was observed in the 3rd trimester compared to the second trimester. Moreover, a significant positive correlation was found between TSH and lipid profile (total cholesterol, triglycerides, and LDL) in both trimesters, but not with HDL. These findings highlight the importance of monitoring thyroid hormone levels in the later stages of pregnancy to avoid potential maternal & fetal complications.

Fluoride exposure and hypothyroidism in a Canadian pregnancy cohort

BackgroundWhile fluoride can have thyroid-disrupting effects, associations between low-level fluoride exposure and thyroid conditions remain unclear, especially during pregnancy when insufficient thyroid hormones can adversely impact offspring development. ObjectivesWe evaluated associations between fluoride exposure and hypothyroidism in a Canadian pregnancy cohort. MethodsWe measured fluoride concentrations in drinking water and three dilution-corrected urine samples and estimated fluoride intake based on self-reported beverage consumption. We classified women enrolled in the Maternal-Infant Research on Environmental Chemicals Study as euthyroid (n = 1301), subclinical hypothyroid (n = 100) or primary hypothyroid (n = 107) based on their thyroid hormone levels in trimester one. We used multinomial logistic regression to estimate the association between fluoride exposure and classification of either subclinical or primary hypothyroidism and considered maternal thyroid peroxidase antibody (TPOAb) status, a marker of autoimmune hypothyroidism, as an effect modifier. In a subsample of 466 mother-child pairs, we used linear regression to explore the association between maternal hypothyroidism and child Full-Scale IQ (FSIQ) at ages 3-to-4 years and tested for effect modification by child sex. ResultsA 0.5 mg/L increase in drinking water fluoride concentration was associated with a 1.65 (95 % confidence interval [CI]: 1.04, 2.60) increased odds of primary hypothyroidism. In contrast, we did not find a significant association between urinary fluoride (adjusted odds ratio [aOR]: 1.00; 95%CI: 0.73, 1.39) or fluoride intake (aOR: 1.25; 95%CI: 0.99, 1.57) and hypothyroidism. Among women with normal TPOAb levels, the risk of primary hypothyroidism increased with both increasing water fluoride and fluoride intake (aOR water fluoride concentration: 2.85; 95%CI: 1.25, 6.50; aOR fluoride intake: 1.75; 95%CI: 1.27, 2.41). Children born to women with primary hypothyroidism had lower FSIQ scores compared to children of euthyroid women, especially among boys (B coefficient: −8.42; 95 % CI: −15.33, −1.50). DiscussionFluoride in drinking water was associated with increased risk of hypothyroidism in pregnant women. Thyroid disruption may contribute to developmental neurotoxicity of fluoride.

Associations between exposure to phthalates and subclinical hypothyroidism in pregnant women during early pregnancy: A pilot case-control study in China

Phthalates are environmental endocrine disruptors with thyroid-disrupting properties; however, the association between phthalate exposure and subclinical hypothyroidism (SCH) during pregnancy is unknown. We recruited a study population from a cohort of pregnant women in Beijing, China, and conducted the present pilot case-control study of 42 SCH cases and 84 non-SCH controls matched with age and body mass index (BMI). Serum levels of thyroid peroxidase antibody, free thyroxine (FT4), thyroid-stimulating hormone (TSH), and urinary levels of ten phthalate metabolites during early pregnancy were measured. Urinary monoethyl phthalate (MEP) levels in SCH cases were observably higher than those in controls (p = 0.01). Conditional logistic regression analysis revealed that mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), MEP, mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and di-(2-ethylhexyl) phthalate (ΣDEHP) were significantly associated with a higher risk of SCH during early pregnancy (adjusted odds ratios = 1.89, 1.42, 1.81, and 1.92, respectively). Concomitantly, multiple linear regression analysis showed that MECPP, MEOHP, and ΣDEHP were positively associated with TSH and FT4 × TSH in the entire study population. Bayesian kernel machine regression analysis and stratified analysis by BMI revealed upward tendencies in the serum levels of TSH and FT4 × TSH. In summary, exposure to phthalates, especially DEHP, may be associated with a higher risk of SCH during early pregnancy, and a possible mechanism is the disruption of the hypothalamus-pituitary-thyroid axis.

A cross-sectional study to assess hypothyroid status of pregnant women at 12–16 weeks of gestation

Background: Physiological changes occur during pregnancy. These changes include metabolic, hematologic, cardiovascular, renal, and respiratory changes. In some cases, these changes may alter and lead to complications which result in adverse pregnancy outcomes. In India, hypothyroidism in pregnancy has a prevalence of 4.8–11%. Aims and Objectives: The aim of this study was to estimate the prevalence of hypothyroidism in pregnant women at 12–16 weeks of gestation. Materials and Methods: A cross-sectional study was planned on pregnant women attending the ANC clinic of Outpatient Department of Obstetrics and Gynecology at K.L. E’S Dr Prabhakar Kore Hospital and Medical Research Center Belagavi. Serum thyroid stimulating hormone (TSH) was estimated in the study participants. Serum TSH levels &gt;4.5 μIU/ml were labeled as hypothyroid pregnant women. Results: In our study, the prevalence of hypothyroidism was observed to be 8.68%. Conclusion: Hence, we conclude that all pregnant women should be screened for hypothyroidism at earlier weeks of gestation.

ODP534 Repercussions of Thyroid Autoimmunity on Neonatal Outcomes in Pregnant Hypothyroid Women

Abstract Introduction The impact of thyroid autoimmunity in pregnancy on neonatal outcomes remains unclear. Studies to date have revealed a positive correlation between thyroid antibodies and preterm births and miscarriages. However other aspects of neonatal outcomes need further exploration. Advanced maternal age is associated with the escalation of the prevalence of thyroid antibodies. Not only this, advanced maternal age in itself is a proven factor for unfavourable fetal outcomes. Most of the studies to date in this regard have an age-related bias as women of all groups were included to assess the neonatal outcomes in women with thyroid antibodies. Our study was conducted in hypothyroid women who were less than 35 years of age with thyroid antibodies to assess outcomes on the neonates unbiased of advanced maternal age. Hypothesis To evaluate the effects of maternal thyroid autoimmunity on neonatal outcomes. Methodology A retrospective chart review was conducted on 7978 women delivered in the study timeline in a secondary hospital of Qatar. 287 women were hypothyroid and out of these 198 women with age less than 35 years were included in the study. Neonatal outcomes such as preterm births, small for date babies, admission to neonatal intensive care units (NICU) and intrauterine fetal deaths (IUFD) were noted and compared with 200 euthyroid women who were selected by random sampling. Statistical Package for the Social Sciences version 27. 0 was used for statistical analysis. The Odds’ ratio was calculated and results with a value of p&amp;lt;0. 05 was considered significant. Results Thyroid autoimmunity was noted in 30.30% of hypothyroid pregnant women. All these women had thyroid peroxidase antibody and thyroglobulin antibody was observed in 4.44%. The range of TPO antibodies was 67-1350 IU/ml (mean 497 IU/ml). 10% vs 4.5% (OR- 2.22, 95%CI-0.760 to 6.495, P = 0.14) preterm births and 10% vs 3% (OR-3.33, 95%CI-1. 037-10.71, p&amp;lt;0. 05) small for dates babies were observed in women with thyroid antibodies in comparison to the control (euthyroid pregnant women). Higher incidence of NICU admissions (22% Vs 8.5%, p&amp;lt;0. 05) and IUFD rates (5% Vs 0.5%, p&amp;lt;0. 05) were noted in women with thyroid autoimmunity. Conclusion This study demonstrates the detrimental effects of thyroid autoimmunity on neonates of hypothyroid women less than 35 years of age. In this age group of hypothyroid women, testing for thyroid immunity should be considered. Antenatal fetal surveillance is advisable in the presence of thyroid antibodies.