Obstetric and neonatal outcome ofthyroid dysfunction in pregnancy

Abstract

Background & Objectives: Thyroid dysfunction in pregnancy and its impact on pregnancy outcome has been a topic of discussion for long and there is no consensus regarding it among experts worldwide. The aim of the study was to determine the current prevalence of thyroid dysfunction in normal pregnant women and study its impact on obstetric and neonatal outcome.Methods: 618 pregnant women less than 16 weeks of gestation enrolled for the study. Along with routine obstetrical investigations, TSH was done. Free T3 and Free T4 estimated for patients with abnormal TSH. Patients were evaluated at the time of pregnancy termination and obstetrical and perinatal outcomes noted.Results & Discussion: The prevalence of subclinical hypothyroidism, overt hypothyroidism and overt hyperthyroidism were 13.6%, 6% and 0.8% respectively. Maternal outcomes having significant association with overt hypothyroidism were preeclampsia (36.1% vs 11.7%), Oligohydramnios (19.4% vs 5.4%) and fetal distress in labor (19.4% vs 7.9%). Maternal outcomes having significant association with subclinical hypothyroidism were preeclampsia (26.3% vs 11.7%), placenta praevia (7.9%vs3%), dystocia (10.5%vs4.3%) and fetal distress in labour (15.8% vs 7.9%). Intra uterine growth restriction and Neonatal low birth weight also had significant association with hypothyroidism. Congenital hypothyroidism noted in 0.5% of the neonates.Conclusion: The prevalence of thyroid dysfunction was high in our study with significant associated adverse outcomes. Hence, routine screening of thyroid dysfunction is recommended.