SUBCLINICAL HYPOTHYROIDISM IN PREGNANCY; IS THERE A NEED FOR PHARMACOLOGICAL INTERVENTION?


Shripad Hebbar, Sahan Kumar, Sapna Amin, Sneha Doizode

Abstract


Objective: To find the prevalence of subclinical hypothyroidism in the first trimester of pregnancy and to compare the maternal and perinatal outcome in them with euthyroid mothers.

Methods: The present study was a prospective observational case-control study done in a tertiary hospital over the period of one and half years. Pregnant women in the first trimester of pregnancy were tested for Thyroid Stimulating Hormone (TSH) levels and those who had TSH>2.5mIU/l, free T3 and free T4 estimation was carried out on the same sample. A total of 171 women could be followed up till delivery and their first-trimester thyroid profile was available for analysis. They were grouped into two groups, Group 1: all women with TSH level>2.5 mIU/l, considered to be hypothyroid (n=79), Group 2: women with euthyroid status with TSH levels 0.1 to 2.5 mIU/l (n=95). All the neonates delivered in the first group had cord blood TSH estimation.

Results: In the study period, there were 2632 deliveries. The number of pregnant women with first trimester TSH levels>2.5 mIU/l were 79, giving the prevalence rate of 3 % for subclinical hypothyroidism during pregnancy. The obstetric complications observed were gestational hypertension 3.8%, gestational diabetes 6.3%, placenta praevia1.3% and preterm delivery 7.6%. The perinatal complications included Intrauterine growth restriction (IUGR) 1.3%, Low Birth Weight (LBW) 3.8%, perinatal asphyxia 2.5% and neonatal hypothyroidism 1.3%. Only preterm delivery appeared to be significantly associated with subclinical hypothyroidism.

Conclusion: The observed complication rates were much similar, in fact, lesser with gestational diabetes, pregnancy hypertension, IUGR, LBW compared to global and Indian prevalence rates. This indicates that the cut-off for diagnosing subclinical hypothyroidism should be derived from TSH assays from the local geographic population and should guide the treating physician to establish appropriate TSH ranges where definite therapeutic intervention is required to improve the maternal and foetal outcome.


Keywords


Thyroid hormones, Subclinical hypothyroidism, Pregnancy complications, Levothyroxine

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About this article

Title

SUBCLINICAL HYPOTHYROIDISM IN PREGNANCY; IS THERE A NEED FOR PHARMACOLOGICAL INTERVENTION?

Keywords

Thyroid hormones, Subclinical hypothyroidism, Pregnancy complications, Levothyroxine

DOI

10.22159/ijpps.2017v9i3.16542

Date

03-02-2017

Additional Links

Manuscript Submission

Journal

International Journal of Pharmacy and Pharmaceutical Sciences
Vol 9, Issue 3, 2017 Page: 186-191

Online ISSN

0975-1491

Statistics

119 Views | 243 Downloads

Authors & Affiliations

Shripad Hebbar
Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576102
India

Sahan Kumar
Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576102
India

Sapna Amin
Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576102
India

Sneha Doizode
Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka 576102
India


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