Department of Obstetrics & Gynecology, R.D. Gardi Medical College, Ujjain, Pin-456006, India.
BMC Pregnancy Childbirth. 2020 Dec 10;20(1):769. doi: 10.1186/s12884-020-03448-z.
Pregnancy is a stress test of maternal thyroid function. The prevalence of thyroid dysfunction in pregnant women is high. Subclinical hypothyroidism occurs in 10% of all pregnancies. Effects of hypothyroidism in pregnancy are anemia, low birth weight and mental retardation in neonate. This study is aimed to evaluate maternal and fetal outcomes in pregnant women with deranged thyroid profile. The relevance of this study is to document the association of hypothyroidism and its adverse effects on mother and fetus.
This prospective observational study was carried out at R.D. Gardi Medical College, Ujjain, India. Subjects of this study were 198 antenatal women in third trimester with singleton pregnancy admitted in the obstetric ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residence and socioeconomic status. Women with multiple pregnancy, a known case of thyroid disorder, or any pre-existing medical disorder were excluded. Routine hematological parameters and estimation of T3, T4 and TSH was conducted. Patients with deranged thyroid profile were subsequently assessed for maternal and fetal complications. History of infertility, family history of thyroid disease, menstrual pattern, recurrent abortion, hemoglobin level and fetal outcome were the main study variables. Data was analysed in SPSS software for statistical co-relation.
Prevalence of thyroid disorder is 11%; with subclinical hypothyroidism, overt hypothyroidism and subclinical hyperthyroidism occurring in 5.6, 3.5 and 1.5% of subjects respectively. In women with subclinical and overt hypothyroidism, anemia was present in 26.3% being significantly associated with hypothyroidism (p = 0.008). With respect to fetal outcome, LBW 31.6% (p = 0.001), NICU admission 42.1%, (p = 0.000) and low APGAR Score (21.1%, p = 0.042) were statistically associated with hypothyroidism. Risk of anemia, Low Birth weight, NICU admissions, and low APGAR score was 4.8, 6.3, 0.14 and 3.64 times higher respectively in women with hypothyroidism than in women who are euthyroid.
Prevalence of subclinical hypothyroidism is 5.6% in 3rd trimester of pregnancy. Anemia, pre-eclampsia, high caesarean rates and neonatal morbidities is significantly associated with hypothyroidism.
妊娠是对母体甲状腺功能的一项应激测试。孕妇甲状腺功能障碍的患病率很高。亚临床甲状腺功能减退症在所有妊娠中占 10%。妊娠期间甲状腺功能减退症的影响包括新生儿贫血、低出生体重和智力障碍。本研究旨在评估甲状腺功能异常孕妇的母婴结局。本研究的相关性在于记录甲状腺功能减退症及其对母婴的不良影响。
这是一项在印度乌贾因的 R.D. Gardi 医学院进行的前瞻性观察研究。本研究的对象是 198 名在产科病房住院的孕晚期单胎妊娠的孕妇，获得了知情同意。选择的对象不论年龄、产次、居住地和社会经济地位如何。排除了多胎妊娠、已知甲状腺疾病或任何现有医疗疾病的患者。进行了常规血液学参数和 T3、T4 和 TSH 的测定。随后对甲状腺功能异常的患者进行了母婴并发症评估。不孕史、甲状腺疾病家族史、月经模式、复发性流产、血红蛋白水平和胎儿结局是主要的研究变量。数据在 SPSS 软件中进行了统计学分析。
甲状腺疾病的患病率为 11%；亚临床甲状腺功能减退症、显性甲状腺功能减退症和亚临床甲状腺功能亢进症的患病率分别为 5.6%、3.5%和 1.5%。在亚临床和显性甲状腺功能减退症的女性中，贫血的发生率为 26.3%，与甲状腺功能减退症显著相关（p=0.008）。在胎儿结局方面，低出生体重（LBW）为 31.6%（p=0.001）、新生儿重症监护病房（NICU）入院率为 42.1%（p=0.000）和低阿普加评分（21.1%，p=0.042）与甲状腺功能减退症显著相关。与甲状腺功能正常的女性相比，甲状腺功能减退症女性贫血、低出生体重、NICU 入院和低阿普加评分的风险分别高 4.8、6.3、0.14 和 3.64 倍。
妊娠晚期亚临床甲状腺功能减退症的患病率为 5.6%。贫血、子痫前期、剖宫产率和新生儿发病率与甲状腺功能减退症显著相关。
