Evaluation of Thyroid Function during Pregnancy and Effects of Thyroid Dysfunction on Maternal Outcome: A Prospective Cross Sectional Study in a Tertiary Care Hospital in Northern India

Abstract

Background: Thyroid disorders are prevalent in women of child-bearing age and for this reason commonly present in pregnancy and the puerperium. Thyroid disease is the second most common endocrine disease to affect women of reproductive age. Uncorrected thyroid dysfunction in pregnancy has adverse effects maternal well-being [1]. In this context, the study was conducted with the objective to evaluate the thyroid function in pregnant females attending antenatal clinic at Post Graduate Department of Obstetrics and Gynaecology, SKIMS, Soura and to study the adverse effects of thyroid dysfunction on maternal health. Methods: This prospective cross sectional study was carried out in pregnant women who attended the antenatal clinic at post graduate department of obstetrics and gynecology, SKIMS from September 2018 for a period of 12 months. The study cases selected were pregnant women at 10 weeks of gestation and their TSH, T3, T4 levels were evaluated as is done here as a routine antenatal work up. Total of 600 patients were taken from the said gestational age and were evaluated for TSH, T3, T4 levels. Well informed consent was taken from all patients. Only those subjects who met the eligibility criteria, as described later were taken for study. After proper scrutiny, 600 patients who were fit to be included in study were selected. For thyroid function test (TFT) 10 ml of blood sample of pregnant women was drawn at 10 weeks in the first trimester. TFT were assessed by quantitative analysis of serum. Depending upon the fasting TSH values they were grouped as group A including patients having TSH > 2.5mIU/L, and patients with TSH < 0.1mIU/Land group B having TSH levels of 0.1mIU/l– 2.5mIU/L. Results: The mean age of the population studied was 25.31+/-4.20 years (mean age +/-SD). The range was from 18 – 38 years. 232 patients (38.6%) were from urban areas and 368 patients (61.38%) were from rural areas. The patients with TSH value of > 2.5mIU/L and < 0.1mIU/L were taken as Group A, and patients with TSH value of 0.1 – 2.5mIU/L were taken as Group B. It was observed that rates of abortion, pre eclampsia, preterm labour, IUGR and placental abruptionwere significantly higher in group A. The rates of GDM, stillbirth, PPH, congenital malformations, however, were comparable between the two groups.