PREVALENCE OF SUB CLINICAL HYPOTHYROIDISM IN PREGNANCY IN NORTH INDIAN POPULATION
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Keywords
Subclinical hypothyroidism, euthyroid, Pregnancy, Overt Hypothyroidism
Abstract
Objectives: Subclinical hypothyroidism (SCH) is the most common endocrinological abnormality associated with pregnancy. Subclinical hypothyroidism is known to affect maternal and fetal outcomes adversely. This study aimed to find the prevalence of subclinical hypothyroidism in pregnancy, particularly in the North Indian population. Material and method: The following study was conducted in a tertiary care center Dr. S.S. Tantia Medical College, Hospital and Research Center, Sri Ganganagar, to estimate the prevalence of subclinical hypothyroidism in pregnant women. A total of 200 pregnant women at their first antenatal checkup (ANC) were enrolled in the study. Serum thyroid-stimulating hormone (TSH), free T4 (FT4) was evaluated. The static analysis was done by SPSS version 16. Results: Out of the 200 cases, 103 were found to have SCH, and 37 cases were observed as overt hypothyroidism. In our study, 30% of euthyroid pregnant women were observed. There is no association seen in this study between gestational age and subclinical hypothyroidism. Most SCH cases were reported in the age group of 26-30 years. Conclusion: Pregnancy is associated with significant alterations in the regulation of thyroid function. The developing fetus relies on the mother for thyroid hormone synthesis in the early first trimester of pregnancy around 10-12 weeks. Thyroid hormones are crucial for neuronal development of the fetus. Hence, subclinical hypothyroidism affects both maternal and fetal outcomes. So, it is better to recommend screening of TSH levels in all pregnant women.
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1. Talat A, Khan AA, Nasreen S, Wass JA: Thyroid screening during early pregnancy and the need for trimester-specific reference ranges: a cross-sectional study in Lahore, Pakistan. Cureus. 2019, 11:e5661. 10.7759/cureus.5661 2. Nambiar V, Jagtap VS, Sarathi V, Lila AR, Kamalanathan S, Bandgar TR, et al. Prevalence and impact of thyroid disorders on maternal outcome in Asian-Indian pregnant women. J Thyroid Res. 2011;2011:429097 3. Gupta M et al. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017 May;6(5):1909-1914 4. Moleti M, Lo Presti VP, Campolo MC, Mattina F, Galletti M, Mandolfino M, et al. Iodine prophylaxis using iodized salt and risk of maternal thyroid failure in conditions of mild iodine deficiency. J Clin Endocrinol Metab 2008; 93: 2616 - 21. 5. Lockwood CM, Grenache DG, Gronowski AM. Serum human chorionic gonadotropin concentrations greater than 400,000 IU/L are invariably associated with suppressed serum thyrotropin concentrations. Thyroid 2009; 19: 863 -8. 6. Soldin OP, Soldin D, Sastoque M. Gestation-specific thyroxine and thyroid stimulating hormone levels in the United States and worldwide. Ther Drug Monit 2007; 29: 553 -9. 7. Kwakkel J, Surovtseva OV, de Vries EM, Stap J, Fliers E, Boelen A: A novel role for the thyroid hormone activating enzyme type 2 deiodinase in the inflammatory response of macrophages. Endocrinology. 2014, 155:2725-34. 10.1210/en.2013-2066 8. Utiger RD: Maternal hypothyroidism and fetal development. N Engl J Med. 1999, 341:601-2. 10.1056/NEJM199908193410809 9. Dash P, Tiwari R, Nayak S, et al. (January 10, 2022) Prevalence of Subclinical Hypothyroidism in Pregnancy and Its Association With Antithyroperoxidase Antibody and the Occurrence of Gestational Diabetes Mellitus. Cureus 14(1): e21087. DOI 10.7759/cureus.21087 10. Casey BM, Dashe JS, Wells CE, et al.: Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005, 106:198-199. 10.1097/01.aog.0000169597.61122.be 11. Kilby MD, Verhaeg J, Gittoes N, Somerset DA, Clark PM, Franklyn JA: Circulating thyroid hormone concentrations and placental thyroid hormone receptor expression in normal human pregnancy and pregnancy complicated by intrauterine growth restriction (IUGR). J Clin Endocrinol Metab. 1998, 83:2964- 71. 10.1210/jcem.83.8.5002 12. Shields BM, Knight BA, Hill A, Hattersley AT, Vaidya B: Fetal thyroid hormone level at birth is associated with fetal growth. J Clin Endocrinol Metab. 2011, 96:E934-8. 10.1210/jc.2010-2814 13. Ajmani et al. The Journal of Obstetrics and Gynecology of India (2014) 64(2):105–110 14. Stagnaro-Green A. Thyroid antibodies and miscarriage: Where are we at a generation later? J Thyroid Res 2011. 2011:841949. [PMC free article] [PubMed] [Google Scholar] [Ref list] 15. Ghassabian A, Bongers-Schokking JJ, de Rijke YB, van Mil N, Jaddoe VW, de Muinck Keizer-Schrama SM, et al. Maternal thyroid autoimmunity during pregnancy and the risk of attention deficit/hyperactivity problems in children: The generation R study. Thyroid. 2012;22:178–86. 16. LeBeau SO, Mandel SJ. Thyroid disorders during pregnancy. Endocrinol Metab Clin North Am. 2006;35:117–36. [PubMed] [Google Scholar] [Ref list]
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